title: Knowledge synthesis methods for generating or refining theory: a scoping review reveals that little guidance is available.
abstract: To describe and compare, through a scoping review, emerging knowledge synthesis methods for generating and refining theory, in terms of expertise required, similarities, differences, strengths, limitations, and steps involved in using the methods.
  
  
  
  Electronic databases (e.g., MEDLINE) were searched, and two reviewers independently selected studies and abstracted data for qualitative analysis.
  
  
  
  In total, 287 articles reporting nine knowledge synthesis methods (concept synthesis, critical interpretive synthesis, integrative review, meta-ethnography, meta-interpretation, meta-study, meta-synthesis, narrative synthesis, and realist review) were included after screening of 17,962 citations and 1,010 full-text articles. Strengths of the methods included comprehensive synthesis providing rich contextual data and suitability for identifying gaps in the literature, informing policy, aiding in clinical decisions, addressing complex research questions, and synthesizing patient preferences, beliefs, and values. However, many of the methods were highly subjective and not reproducible. For integrative review, meta-ethnography, and realist review, guidance was provided on all steps of the review process, whereas meta-synthesis had guidance on the fewest number of steps.
  
  
  
  Guidance for conducting the steps was often vague and sometimes absent. Further work is needed to provide direction on operationalizing these methods.
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7, Canada.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Tricco
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada.
authors.forename: Jesmin
authors.initials: J
authors.lastname: Antony
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Ontario M5T 3M6, Canada.
authors.forename: Charlene
authors.initials: C
authors.lastname: Soobiah
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7, Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Kastner
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada.
authors.forename: Elise
authors.initials: E
authors.lastname: Cogo
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: MacDonald
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: D'Souza
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada.
authors.forename: Wing
authors.initials: W
authors.lastname: Hui
authors.affiliation: Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario M5B 1W8, Canada; Department of Geriatric Medicine, Faculty of Medicine, University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada. Electronic address: Sharon.Straus@utoronto.ca.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
mesh_terms: D016208:Databases, Factual; D015340:Epidemiologic Research Design; D006801:Humans; D012196:Review Literature as Topic
keywords: Critical interpretive synthesis; Integrative review; Knowledge synthesis; Meta-ethnography; Meta-synthesis; Realist review