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RAMESES  August 2011

RAMESES August 2011

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Subject:

Re: Interim summary - meta-narrative reviews

From:

Trisha Greenhalgh <[log in to unmask]>

Reply-To:

Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]>, Trisha Greenhalgh <[log in to unmask]>

Date:

Thu, 11 Aug 2011 20:24:48 +0100

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Thanks Geoff.  I think you should add the note you sent to me "a research
tradition is what researchers get up to WITHIN a paradigm".

Example: A paradigm might be epidemiology.  Within that paradigm there is a
research tradition centred around the development of risk scores for
diabetes. To characterise the paradigm, we could set out the philosophical
assumptions shared by those who work in it (about the world being 'out
there', unproblematically measurable, open to prediction, with linear links
between causes and effects, much store being set by multiple regression, and
context being viewed in terms of mediators and moderators etc etc).  That is
the lens through which most diabetes risk scores have been developed.  

The diabetes risk score research tradition began when the first team decided
to develop a risk score by measuring XYZ on a population and putting the
data into a computer, and this tradition has been unfolding as 93 more teams
have copied this method, adapted it, challenged it, produced "better" scores
and so on.  At some point, someone (e.g. a clever chap currently working for
me) is going to come along and say hey, this is all pretty futile, let's
think differently about this whole issue, and he'll take his football and go
to a different [paradigmatic] field, and a new research tradition [within
the new paradigm] will begin.  

So the meta-narrative is BOTH the paradigmatic assumptions AND the story of
how the primary studies came about and built on one another.  



Trisha Greenhalgh
Professor of Primary Health Care and Director, Healthcare Innovation and
Policy Unit
Centre for Primary Care and Public Health
Blizard Institute
Barts and The London School of Medicine and Dentistry
Yvonne Carter Building
58 Turner Street
London E1 2AB
t : 020 7882 7325 (PA) or 7326 (dir line)
f : 020 7882 2552
e: [log in to unmask] 


http://www.icms.qmul.ac.uk/chs/staff/trishagreenhalgh.html


-----Original Message-----
From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards
[mailto:[log in to unmask]] On Behalf Of Geoff Wong
Sent: 11 August 2011 18:46
To: [log in to unmask]
Subject: Interim summary - meta-narrative reviews

I am going to have a stab at summarising what I suspect are the main
'messages' that have come out of a number of detailed postings that make up
the threads relating to meta-narrative reviews (MNR). I hope my efforts to
condense (and relative ignorance about MNR methodology) will not do an
injustice to the depth of some of the discussions. If I have, do tell me and
correct any of my errors or omissions.

UNIT OF ANALYSIS
Questions were variously asked about what the differences were between
'story line' vs. 'narrative' vs. 'meta-narrative' vs. 'discipline', vs
'tradition'. And seemingly the implicit question was which one should I use
to analyse the data with?
MNR aims to make sense of diverse literature where concepts have been
defined and researched differently because of the researchers' accepted
practice and beliefs. This is where Kuhn comes in with his concept of a
paradigm, but a finer grain 'unit of analysis' is deemed to be more useful
as within a paradigm there may be more than just one set of  practice and
beliefs. Experience to date with MNR does seem to indicate that the
'tradition' is a useful unit of analysis.
A research tradition is defined as defined "as a coherent body of
theoretical knowledge and a linked set of primary studies in which
successive studies are influenced by the findings of previous studies"
(I realise Ihave not 'defined' the other terms. You probably know this, but
definitions may be found in Greenhalgh et al.'s 'Storylines of research in
diffusion of innovation: a meta-narrative approach to systematic review'
Social Science & Medicine 61 (2005) 417-430 and 'Tensions and Paradoxes in
Electronic Patient Record Research: A Systematic Literature Review Using the
Meta-narrative Method The Milbank Quarterly, Vol. 87, No. 4, 2009 (pp.
729-788)' has a Glossary).

A question that arose was how many meta-narratives need to be mapped. The
answer given was more than one, because if a concept was defined and
researched in pretty much the same way by everyone, then a MNR would
probably not be the ideal method to use.

CROSS TALK
As traditions evolve and change, one assumption was that there was some
means of communication within and between traditions. It was raised that
this may not necessarily be happening and questions arose about whether it
was possible to map such talk (or its absence) and/or what the implication
was to the mapping process if none of this 'cross talk' occured. 


THE SOCIAL DIMENSION and FOUCAULT
Whilst Kuhn suggests that knowlegde is a social construct, one weakness
raised in his writings is that of the influence of the social dimension on
knowledge construction. Foucault's knowledge-power theoretical lens could
provide an alternative way of viewing data... does anyone feel like
operationalising this into a review method? Is there a need?


Two other points came up - middle-range theory and software. as these are
more 'generic' issues to both review methods I have started separate threads
on each.

Geoff

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