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. 2018 Jan 25;13(Suppl 1):10.
doi: 10.1186/s13012-017-0689-2.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table

Simon Lewin  1   2 , Meghan Bohren  3 , Arash Rashidian  4   5 , Heather Munthe-Kaas  6 , Claire Glenton  6 , Christopher J Colvin  7 , Ruth Garside  8 , Jane Noyes  9 , Andrew Booth  10 , Özge Tunçalp  3 , Megan Wainwright  7 , Signe Flottorp  6 , Joseph D Tucker  11 , Benedicte Carlsen  12
Affiliations

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table

Simon Lewin et al. Implement Sci. .

Abstract

Background: The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on making an overall assessment of confidence in a review finding and creating a CERQual Evidence Profile and a CERQual Summary of Qualitative Findings table.

Methods: We developed this guidance by examining the methods used by other GRADE approaches, gathering feedback from relevant research communities and developing consensus through project group meetings. We then piloted the guidance on several qualitative evidence syntheses before agreeing on the approach.

Results: Confidence in the evidence is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. Creating a summary of each review finding and deciding whether or not CERQual should be used are important steps prior to assessing confidence. Confidence should be assessed for each review finding individually, based on the judgements made for each of the four CERQual components. Four levels are used to describe the overall assessment of confidence: high, moderate, low or very low. The overall CERQual assessment for each review finding should be explained in a CERQual Evidence Profile and Summary of Qualitative Findings table.

Conclusions: Structuring and summarising review findings, assessing confidence in those findings using CERQual and creating a CERQual Evidence Profile and Summary of Qualitative Findings table should be essential components of undertaking qualitative evidence syntheses. This paper describes the end point of a CERQual assessment and should be read in conjunction with the other papers in the series that provide information on assessing individual CERQual components.

Keywords: Confidence; Evidence-based practice; GRADE; Guidance; Methodology; Qualitative evidence synthesis; Qualitative research; Research design; Systematic review methodology.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable. This study did not undertake any formal data collection involving any humans or animals.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overview of the GRADE-CERQual series of papers
Fig. 2
Fig. 2
Making an overall CERQual assessment of confidence in each individual review finding
See this image and copyright information in PMC

References

    1. Lewin S, Booth A, Glenton C, Munthe-Kaas HM, Rashidian A, Wainwright M, Bohren MA, Tuncalp Ö, Colvin CJ, Garside R, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series. Implement Sci. 2018;13(Suppl 1): 10.1186/s13012-017-0688-3. - PMC - PubMed
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    1. Lewin S, Glenton C, Munthe-Kaas H, Carlsen B, Colvin CJ, Gulmezoglu M, Noyes J, Booth A, Garside R, Rashidian A. Using qualitative evidence in decision making for health and social interventions: an approach to assess confidence in findings from qualitative evidence syntheses (GRADE-CERQual) PLoS Med. 2015;12(10):e1001895. doi: 10.1371/journal.pmed.1001895. - DOI - PMC - PubMed
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    1. Munthe-Kaas HM, Bohren M, Carlsen B, Glenton C, Lewin S, Colvin CJ, Tuncalp Ö, Noyes J, Booth A, Garside R, et al. Applying GRADE-CERQual to qualitative evidence synthesis findings—paper 3: how to assess methodological limitations. Implement Sci. 2018;13(Suppl 1): 10.1186/s13012-017-0690-9. - PMC - PubMed

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