Using visual methods to further enhance qualitative evidence synthesis.

Background: The use of visual methods in qualitative evidence synthesis (QES) adds a valuable dimension to the synthesis process by enhancing understanding and knowledge generation. Visual methods are currently underused and underreported in QES. Methods: This is the first study to describe accessible visual methods that support various stages of QES and to show the application of visual methods to a Cochrane QES of 43 studies using meta-ethnography and systematic review methods. This study also addresses the involvement of stakeholders including the public, practical considerations of equity, diversity, inclusion, and reflexivity in the selection and application of visual methods. Results: In a novel approach, the review authors utilized a combination of remote and in-person visual methods to initiate and develop their synthesis, involving stakeholders throughout the process. The review authors used methods including paper labels, cartoons, infographics, virtual whiteboards, and diagrams. The rigorous use of visual methods in the QES facilitated data visualization, remote analysis meetings, interpretation of extensive data, and meaningful patient and public involvement. Conclusion: QES authors are encouraged to consider the use of visual methods, particularly when involving the public in the synthesis process. When selecting visual methods, authors should consider how they align with the study's objectives, suit the stage of synthesis, might enhance analysis, their available resources, and the team's technical skills.