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Implementation Science
Published in: Implementation Science 1/2018

Open Access 01-01-2018 | Method

Applying GRADE-CERQual to qualitative evidence synthesis findings—paper 4: how to assess coherence

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

Published in: Implementation Science | Special Issue 1/2018

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Abstract

Background

The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE 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) relevance, (3) coherence and (4) adequacy of data. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual’s coherence component.

Methods

We developed the coherence component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual coherence component within several qualitative evidence syntheses before agreeing on the current definition and principles for application.

Results

When applying CERQual, we define coherence as how clear and cogent the fit is between the data from the primary studies and a review finding that synthesises that data. In this paper, we describe the coherence component and its rationale and offer guidance on how to assess coherence in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess coherence, the steps that need to be taken to assess coherence and examples of coherence assessments.

Conclusions

This paper provides guidance for review authors and others on undertaking an assessment of coherence in the context of the CERQual approach. We suggest that threats to coherence may arise when the data supporting a review finding are contradictory, ambiguous or incomplete or where competing theories exist that could be used to synthesise the data. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.
Appendix
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Metadata
Title
Applying GRADE-CERQual to qualitative evidence synthesis findings—paper 4: how to assess coherence
Authors
Christopher J. Colvin
Ruth Garside
Megan Wainwright
Heather Munthe-Kaas
Claire Glenton
Meghan A. Bohren
Benedicte Carlsen
Özge Tunçalp
Jane Noyes
Andrew Booth
Arash Rashidian
Signe Flottorp
Simon Lewin
Publication date
01-01-2018
Publisher
BioMed Central
Published in
Implementation Science / Issue Special Issue 1/2018
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-017-0691-8

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