Multi-context versus context-specific qualitative evidence syntheses: combining the best of both.

There is an increasing interest in the conduct of qualitative evidence syntheses (QES), particularly in the field of health care. Approaches to QES vary in the way they conduct a search, a critical appraisal or the data-analysis. To date, the use of multi-context versus context-specific QES has not yet been fully considered. In a multi-context, QES exhaustive searches are used that retrieve studies from a broad variety of geographical, socio-cultural, political, historical, economical, health care, linguistic, or other context relevant to the review. Authors of a context-specific QES would generally have a particular end user in mind, therefore, using a selective search strategy with a focus on one particular context in order to provide lines of actions or theories that are sensitive to a local setting. We used the insights from a recently conducted, context-specific QES to map out potential strengths and weaknesses of these two approaches and make recommendations regarding the future conduct of QES. We propose two ways of combining the best of both: the production of umbrella reviews of context-specific syntheses and/or the trans-cultural modification and trans-contextual adaptation of findings from multi-context syntheses.