GRADE CERQual
Publisert
The GRADE-CERQual approach provides a transparent method for assessing the confidence of evidence from reviews of qualitative research, and indicating this confidence to end users, such as guideline panels or decision makers.
About this phase
What happens before this step | Completed the synthesis and filled in the GRADE CERQual findings templates |
Description | Assessing the confidence in the findings |
Why is this step important? | The assessment of the confidence you have in the findings is an important indication to decision makers and the reader about how certain we are that what the finding is a true representation of what is happening |
Responsible | Project leader and one or two project members |
Tasks | Conduct CERQual assessments |
Tools | Interactive SoQF software |
Deliverable | Your CERQual assessments SoQF tables Evidence profiles |
The GRADE-CERQual approach provides a transparent method for assessing the confidence of evidence from reviews of qualitative research, and indicating this confidence to end users, such as guideline panels or decision makers. GRADE-CERQual uses a similar approach conceptually to other GRADE tools but is intended for findings from systematic reviews of qualitative evidence. It consists of four components:
- Methodological limitations of included studies: the extent to which there are concerns about the design or conduct of the primary studies that contributed evidence to an individual review finding.
- Coherence of the review finding: an assessment of how clear and cogent the fit is between the data from the primary studies and a review finding that synthesises those data. By cogent, we mean well supported or compelling.
- Adequacy of the data contributing to a review finding: an overall determination of the degree of richness and quantity of data supporting a review finding.
- Relevance of the included studies to the review question: the extent to which the body of evidence from the primary studies supporting a review finding is applicable to the context (perspective or population, phenomenon of interest, setting) specified in the review question.
After assessing each of the four components, a judgement about the overall confidence in the evidence supporting the review finding is made. Confidence is judged as high, moderate, low, or very low. The final assessment is based on consensus among the review authors. All findings start as high confidence and are then be graded down if there are important concerns regarding any of the GRADE-CERQual components.
If the review team does not have experience with GRADE CERQual it is highly recommended to attend a training session before beginning, as well as involving a researcher with experience in CERQual discussions.
Relevant resources:
Applying GRADE-CERQual to Qualitative Evidence Syntesis Findings - Implementation Science Supplement
Lewin S, Booth A, Glenton C, Munthe-Kaas H, Rashidian A, Wainwright M, Bohren MA, Tunçalp Ö, Colvin CJ, Garside R, Carlsen B, Langlois EV, Noyes J. Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series. Implement Sci. 2018 Jan 25;13(Suppl 1):2 https://doi.org/10.1186/s13012-017-0688-3
Lewin S, Bohren M, Rashidian A, Munthe-Kaas H, Glenton C, Colvin CJ, Garside R, Noyes J, Booth A, Tunçalp Ö, Wainwright M, Flottorp S, Tucker JD, Carlsen B. 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. Implement Sci. 2018 Jan 25;13(Suppl 1):10.
Munthe-Kaas H, Bohren MA, Glenton C, Lewin S, Noyes J, Tunçalp Ö, Booth A, Garside R, Colvin CJ, Wainwright M, Rashidian A, Flottorp S, Carlsen B. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations. Implement Sci. 2018 Jan 25;13(Suppl 1):9.
Colvin CJ, Garside R, Wainwright M, Munthe-Kaas H, Glenton C, Bohren MA, Carlsen B, Tunçalp Ö, Noyes J, Booth A, Rashidian A, Flottorp S, Lewin S. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence. Implement Sci. 2018 Jan 25;13(Suppl 1):13.
Glenton C, Carlsen B, Lewin S, Munthe-Kaas H, Colvin CJ, Tunçalp Ö, Bohren MA, Noyes J, Booth A, Garside R, Rashidian A, Flottorp S, Wainwright M. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data. Implement Sci. 2018 Jan 25;13(Suppl 1):14.
Noyes J, Booth A, Lewin S, Carlsen B, Glenton C, Colvin CJ, Garside R, Bohren MA, Rashidian A, Wainwright M, Tunςalp Ö, Chandler J, Flottorp S, Pantoja T, Tucker JD, Munthe-Kaas H. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data. Implement Sci. 2018 Jan 25;13(Suppl 1):4.
Booth A, Lewin S, Glenton C, Munthe-Kaas H, Toews I, Noyes J, Rashidian A, Berg RC, Nyakang'o B, Meerpohl JJ; GRADE-CERQual Coordinating Team. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 7: understanding the potential impacts of dissemination bias. Implement Sci. 2018 Jan 25;13(Suppl 1):12.
Cochrane Webinar series on conducting QES on GRADE CERQual (April 2022)
Templates (See appendix)
- GRADE CERQual assessment template
- GRADE CERQual Summary of Qualitative Findings table template
- GRADE CERQual Evidence profile template