Abstract
Introduction: Qualitative information enables decision-making in health based on feasibility, appropriateness, meaningfulness, patient values, preferences, acceptability, and equity. Despite existing guidelines for synthesizing qualitative data, the process of synthesizing qualitative findings to inform evidence-based policy in the field of Health Technology Assessment (HTA) requires clarification. This review aims to describe the frameworks, tools, and processes used to synthesize qualitative findings to support decision-making in HTA. Method: Using the JBI methodology, the authors accessed databases such as Medline, LILACS, CINAHL, Embase, Web of Science, Scopus, PsycINFO, Cochrane Library, and ScienceDirect. Grey literature searches included PROQUEST, Open Grey, CADTH’s Grey Matters, Google Scholar, and HTA Agencies’ websites. Inclusion criteria focused on synthesizing qualitative evidence frameworks, methods for evidence synthesis, and quality rating. The review had a global scope, without specific population and time restrictions. Data, encompassing fundamental concepts, frameworks, methods, subjects, and objectives, were presented in tables and figures. Result: Out of 2054 articles, 31 were included, mainly from Europe, with a predominant ""guide"" authored by HTA agency and university individuals. The majority of documents did not originate from HTA agencies, but three agencies developed specific documents. A surge in publications occurred in 2018 and 2019. Qualitative data in HTA were justified for opinions, acceptability, feasibility, and equity. SPICE was the most cited acronym; RETREAT was the preferred framework. Thematic synthesis was the most cited method, CASP for quality assessment. GRADE-CERQual graded evidence quality, and ENTREQ was cited for reporting qualitative research. The GRADE EtD framework was the sole tool mentioned for recommendations. Conclusion: This review highlights a growing trend in including qualitative to inform evidence-based policy in HTA. While various proposals suggest instruments and methods, few documents cover all necessary steps, resulting in diverse recommendations. Standardizing processes can improve decision-making by guiding the integration of qualitative evidence, potentially enhancing recommendation quality. This ensures evidence on feasibility, appropriateness, significance, patient values, preferences, acceptability, and equity are considered.
