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J Clin Epidemiol. 2018 Jul;99:41-52. doi: 10.1016/j.jclinepi.2018.03.003. Epub 2018 Mar 13.

Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches.

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Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. Electronic address:
School of Social Sciences, Bangor University, Bangor, UK.
Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK.
Department for Health Services Research, Institute for Public Health and Nursing Research (IPP) and Health Sciences Bremen, University of Bremen, Bremen, Germany.
Center for General Practice, Medical Faculty, Saarland University, Homburg (Saar), Germany; Department of Health Services Research, University of Bremen, Bremen, Germany.
Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, Nijmegen 6500 HB, The Netherlands.
Institute of Bioethics and Medical Humanities, "Agostino Gemelli" School of Medicine, Università Cattolica del Sacro Cuore, 1 Largo F. Vito, Rome 00168, Italy.
Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Marchioninistr. 15, Munich 81377, Germany.



To compare and contrast different methods of qualitative evidence synthesis (QES) against criteria identified from the literature and to map their attributes to inform selection of the most appropriate QES method to answer research questions addressed by qualitative research.


Electronic databases, citation searching, and a study register were used to identify studies reporting QES methods. Attributes compiled from 26 methodological papers (2001-2014) were used as a framework for data extraction. Data were extracted into summary tables by one reviewer and then considered within the author team.


We identified seven considerations determining choice of methods from the methodological literature, encapsulated within the mnemonic Review question-Epistemology-Time/Timescale-Resources-Expertise-Audience and purpose-Type of data. We mapped 15 different published QES methods against these seven criteria. The final framework focuses on stand-alone QES methods but may also hold potential when integrating quantitative and qualitative data.


These findings offer a contemporary perspective as a conceptual basis for future empirical investigation of the advantages and disadvantages of different methods of QES. It is hoped that this will inform appropriate selection of QES approaches.


Qualitative evidence synthesis; Qualitative research; Review methods; Systematic review

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