title: Protocol-developing meta-ethnography reporting guidelines (eMERGe).
abstract: BACKGROUND
  Designing and implementing high-quality health care services and interventions requires robustly synthesised evidence. Syntheses of qualitative research studies can provide evidence of patients' experiences of health conditions; intervention feasibility, appropriateness and acceptability to patients; and advance understanding of health care issues. The unique, interpretive, theory-based meta-ethnography synthesis approach is suited to conveying patients' views and developing theory to inform service design and delivery. However, meta-ethnography reporting is often poor quality, which discourages trust in, and use of, meta-ethnography findings. Users of evidence syntheses require reports that clearly articulate analytical processes and findings. Tailored research reporting guidelines can raise reporting standards but none exists for meta-ethnography. This study aims to create an evidence-based meta-ethnography reporting guideline articulating the methodological standards and depth of reporting required to improve reporting quality.
  
  
  METHODS
  The mixed-methods design of this National Institute of Health Research-funded study (http://www.stir.ac.uk/emerge/) follows good practice in research reporting guideline development comprising: (1) a methodological systematic review (PROSPERO registration: CRD42015024709) to identify recommendations and guidance in conducting/reporting meta-ethnography; (2) a review and audit of published meta-ethnographies to identify good practice principles and develop standards in conduct/reporting; (3) an online workshop and Delphi studies to agree guideline content with 45 international qualitative synthesis experts and 45 other stakeholders including patients; (4) development and wide dissemination of the guideline and its accompanying detailed explanatory document, a report template for National Institute of Health Research commissioned meta-ethnographies, and training materials on guideline use.
  
  
  CONCLUSIONS
  Meta-ethnography, devised in the field of education, is now used widely in other disciplines. Methodological advances relevant to meta-ethnography conduct exist. The extent of discipline-specific adaptations of meta-ethnography and the fit of any adaptions with the underpinning philosophy of meta-ethnography require investigation. Well-reported meta-ethnography findings could inform clinical decision-making. A bespoke meta-ethnography reporting guideline is needed to improve reporting quality, but to be effective potential users must know it exists, trust it and use it. Therefore, a rigorous study has been designed to develop and promote a guideline. By raising reporting quality, the guideline will maximise the likelihood that high-quality meta-ethnographies will contribute robust evidence to improve health care and patient outcomes.
authors.affiliation: Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK. emma.france@stir.ac.uk.
authors.forename: E F
authors.initials: EF
authors.lastname: France
authors.affiliation: School of Health Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK. nicola.ring@stir.ac.uk.
authors.forename: N
authors.initials: N
authors.lastname: Ring
authors.affiliation: School of Social Sciences, Bangor University, Bangor, Gwynedd, LL57 2DG, UK. jane.noyes@bangor.ac.uk.
authors.forename: J
authors.initials: J
authors.lastname: Noyes
authors.affiliation: Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling and Glasgow Caledonian University, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK. margaret.maxwell@stir.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Maxwell
authors.affiliation: Scottish Collaboration for Public Health Research and Policy (SCPHRP), University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, Scotland, UK. Ruth.Jepson@ed.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Jepson
authors.affiliation: Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK. edward.duncan@stir.ac.uk.
authors.forename: E
authors.initials: E
authors.lastname: Duncan
authors.affiliation: Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. TurleyRL@cardiff.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Turley
authors.affiliation: Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK. derek.jones@stir.ac.uk.
authors.forename: D
authors.initials: D
authors.lastname: Jones
authors.affiliation: Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK. Isabelle.uny@stir.ac.uk.
authors.forename: I
authors.initials: I
authors.lastname: Uny
mesh_terms: D000884:Anthropology, Cultural; D019317:Evidence-Based Medicine; D006801:Humans; D036301:Qualitative Research; D012107:Research Design