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Methodology
BioMed Central
Research article
Open Access
Methods for the thematic synthesis of qualitative research in
systematic reviews
James Thomas*+ and Angela Harden+
Address: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, UK
Email: James Thomas* - [email protected]; Angela Harden - [email protected]
* Corresponding author +Equal contributors
Published: 10 July 2008 Received: 17 April 2008
BMC Medical Research Methodology 2008, 8:45 doi:10.1186/1471-2288-8-45 Accepted: 10 July 2008
This article is available from: http://www.biomedcentral.com/1471-2288/8/45
© 2008 Thomas and Harden; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.Org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: There is a growing recognition of the value of synthesising qualitative research in
the evidence base in order to facilitate effective and appropriate health care. In response to this,
methods for undertaking these syntheses are currently being developed. Thematic analysis is a
method that is often used to analyse data in primary qualitative research. This paper reports on the
use of this type of analysis in systematic reviews to bring together and integrate the findings of
multiple qualitative studies.
Methods: We describe thematic synthesis, outline several steps for its conduct and illustrate the
process and outcome of this approach using a completed review of health promotion research.
Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of
'descriptive themes'; and the generation of 'analytical themes'. While the development of
descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage
of interpretation whereby the reviewers 'go beyond' the primary studies and generate new
interpretive constructs, explanations or hypotheses. The use of computer software can facilitate
this method of synthesis; detailed guidance is given on how this can be achieved.
Results: We used thematic synthesis to combine the studies of children's views and identified key
themes to explore in the intervention studies. Most interventions were based in school and often
combined learning about health benefits with 'hands-on' experience. The studies of children's views
suggested that fruit and vegetables should be treated in different ways, and that messages should
not focus on health warnings. Interventions that were in line with these suggestions tended to be
more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies,
synthesising them in a transparent way, and facilitating the explicit production of new concepts and
hypotheses.
Conclusion: We compare thematic synthesis to other methods for the synthesis of qualitative
research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and
tested method that preserves an explicit and transparent link between conclusions and the text of
primary studies; as such it preserves principles that have traditionally been important to systematic
reviewing.
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