Journal Article

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

Lewin, Simon, Wainwright, Megan, Colvin, Christopher J., Rashidian, Arash, Munthe-Kaas, Heather, Garside, Ruth, Noyes, Jane, Flottorp, Signe, Carlsen, Benedicte, Booth, Andrew, Tucker, Joseph D., Bohren, Meghan, Tunçalp, Özge, Glenton, Claire

2018

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Analysis / Biomedical Research - standards / Confidence / Confidence Intervals / Data Accuracy / Data Display - standards / Decision Making / Evidence-Based Medicine - standards / Evidence-based practice / Health Administration / Health Informatics / Health Policy / Health Promotion and Disease Prevention / Health Services Research / Humans / Medical research / Medicine / Medicine & Public Health / Method / Methodology / Methods / Public Health / Publishing - standards / Qualitative evidence synthesis / Qualitative Research / Research design / Systematic review methodology / Systematic Reviews as Topic