top of page

Student Group

Public·29 members
Makar Vorobyov
Makar Vorobyov

Making Paper ? Part 2


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.




Making Paper – part 2



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.


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.


GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) is an approach for assessing how much confidence to place in review findings from systematic reviews of qualitative research or qualitative evidence syntheses (QES). The approach is being developed by the GRADE-CERQual Project Group, a subgroup of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The importance of assessing confidence in qualitative evidence is discussed in the first paper in this series [1].


GRADE-CERQual includes four components for assessing how much confidence to place in review findings: (1) the methodological limitations of the individual qualitative studies contributing to a review finding, (2) the coherence of the review finding, (3) the adequacy of data supporting a review finding and (4) the relevance of the data from the primary studies supporting a review finding to the context (perspective or population, phenomenon of interest and/or setting) specified in the review question. Making an overall assessment of confidence in a review finding involves moving from the judgements made for each CERQual component to a final assessment. The overall assessment of confidence in a review finding takes into account the concerns identified in relation to each of the four components and, in our experience, is an iterative process that benefits from discussion among the review team or those making the CERQual assessment (when this is being done for an existing synthesis).


The aim of this paper, the second in this series (Fig. 1), is to describe and discuss the process for making an overall assessment of confidence in a review finding and to outline how to create a CERQual Evidence Profile and a Summary of Qualitative Findings table. A key part of communicating an overall CERQual assessment is providing an explanation for the confidence assessment, based on the concerns identified in relation to each component. The review team therefore needs to create a Summary of Qualitative Findings table to display a summary of each review finding, the CERQual assessment of confidence in that finding and the explanation for that assessment.


In this paper, we discuss the following processes: firstly, moving from a review finding to a summary of a review finding; secondly, determining the review findings to which CERQual should be applied; thirdly, making an overall CERQual assessment of confidence in each individual review finding; and, finally, creating a CERQual Evidence Profile and a Summary of Qualitative Findings (SoQF) table. Papers 3, 4, 5 and 6 in the series describe how to assess each CERQual component (i.e. methodological limitations [5], coherence [6], adequacy [7], and relevance [8]). These component papers are closely related to this paper on making an overall CERQual assessment of confidence and creating a Summary of Qualitative Findings table. We have placed this paper before the four CERQual component papers as we think that it will be helpful for readers to understand how the component assessments will be used before discussing the details of how to apply each component. Key definitions are provided in Additional file 1.


The initial stages of the process for developing CERQual, which started in 2010, are outlined elsewhere [3]. Since then, we have used a number of methods to further refine the definitions of each component and the principles for application of the