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. 2024 Jun 17;10(2):e004032.
doi: 10.1136/rmdopen-2023-004032.

Synthesis of guidance available for assessing methodological quality and grading of evidence from qualitative research to inform clinical recommendations: a systematic literature review

Mandeep Sekhon  1 , Annette de Thurah  2   3 , George E Fragoulis  4 , Jan Schoones  5 , Tanja A Stamm  6 , Theodora P M Vliet Vlieland  7 , Bente Appel Esbensen  8   9 , Heidi Lempp  10 , Lindsay Bearne  11 , Marios Kouloumas  12 , Polina Pchelnikova  13 , Thijs Willem Swinnen  14 , Chris Blunt  15 , Ricardo J O Ferreira  16   17 , Loreto Carmona  18 , Elena Nikiphorou  19
Affiliations

Synthesis of guidance available for assessing methodological quality and grading of evidence from qualitative research to inform clinical recommendations: a systematic literature review

Mandeep Sekhon et al. RMD Open. .

Abstract

Objective: To understand (1) what guidance exists to assess the methodological quality of qualitative research; (2) what methods exist to grade levels of evidence from qualitative research to inform recommendations within European Alliance of Associations for Rheumatology (EULAR).

Methods: A systematic literature review was performed in multiple databases including PubMed/Medline, EMBASE, Web of Science, COCHRANE and PsycINFO, from inception to 23 October 2020. Eligible studies included primary articles and guideline documents available in English, describing the: (1) development; (2) application of validated tools (eg, checklists); (3) guidance on assessing methodological quality of qualitative research and (4) guidance on grading levels of qualitative evidence. A narrative synthesis was conducted to identify key similarities between included studies.

Results: Of 9073 records retrieved, 51 went through to full-manuscript review, with 15 selected for inclusion. Six articles described methodological tools to assess the quality of qualitative research. The tools evaluated research design, recruitment, ethical rigour, data collection and analysis. Seven articles described one approach, focusing on four key components to determine how much confidence to place in findings from systematic reviews of qualitative research. Two articles focused on grading levels of clinical recommendations based on qualitative evidence; one described a qualitative evidence hierarchy, and another a research pyramid.

Conclusion: There is a lack of consensus on the use of tools, checklists and approaches suitable for appraising the methodological quality of qualitative research and the grading of qualitative evidence to inform clinical practice. This work is expected to facilitate the inclusion of qualitative evidence in the process of developing recommendations at EULAR level.

Keywords: Health services research; Patient Reported Outcome Measures; Qualitative research; Quality Indicators, Health Care.

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Conflict of interest statement

Competing interests: EN has received speaker honoraria/participated in advisory boards for Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Fresenius-Kabi, Lilly and holds research grants from Pfizer and Lilly.

Figures

Figure 1
Figure 1
PRISMA diagram of included papers. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
See this image and copyright information in PMC

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