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循证医学对定性综合的影响:收益与警示。

The Impact of Evidence-Based Medicine on Qualitative Metasynthesis: Benefits to be Harvested and Warnings to be Given.

机构信息

1 Uni Research Health, Bergen, Norway.

2 University of Bergen, Norway.

出版信息

Qual Health Res. 2019 Jan;29(1):7-17. doi: 10.1177/1049732318795864. Epub 2018 Aug 30.

Abstract

Qualitative metasynthesis, developed as an interpretative and inductive methodology, is increasingly influenced by standards from evidence-based medicine, established as a strategy to support policy decisions and guidelines. Currently, principles and procedures from the format developed for systematic reviews are often applied for review and synthesis of all kinds of evidence, including results from qualitative studies. In this article, I substantiate these claims, discussing benefits to be harvested and warnings to be given when qualitative metasynthesis approaches the evidence-based medicine methodology. Situating my exploration in the context of clinical practice, I contrast missions and values of these methodologies regarding review and synthesis of research literature, highlighting potential mismatches between ontology and epistemology, emphasizing challenges regarding sample, analysis, and transferability. Approving systematic and transparent strategies as generic for such purposes, I warn against the idea that methodology developed for evidence-based medicine is a universal gold standard for synthesis of research evidence.

摘要

定性整合分析作为一种解释性和归纳性的方法,越来越受到循证医学标准的影响,后者被确立为支持政策决策和指南的一种策略。目前,系统评价制定的格式的原则和程序通常适用于所有类型的证据(包括定性研究的结果)的审查和综合。在本文中,我将通过讨论定性整合分析方法接近循证医学方法时可能带来的益处和警示,来证实这些说法。我将我的探索置于临床实践的背景下,对比这些方法在研究文献审查和综合方面的使命和价值观,突出本体论和认识论之间可能存在的不匹配,强调关于样本、分析和可转移性的挑战。我赞成将系统和透明的策略作为通用方法,同时警告说,为循证医学开发的方法并不是研究证据综合的普遍黄金标准。

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