Using Qualitative Evidence in Decision Making for Health and Social Interventions: An Approach to Assess Confidence in Findings from Qualitative Evidence Syntheses (GRADE-CERQual)
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Simon Lewin and colleagues present a methodology for increasing transparency and confidence in qualitative research synthesis.
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Downgrades in confidence were primarily driven by methodological limitations related to limited reporting of researcher positioning and reflexivity across contributing studies, and depending on the finding, by context-dependence (relevance) or uneven richness of supporting data (adequacy).
“Downgrades were primarily driven by methodological limitations related to limited reporting of researcher positioning and reflexivity across contributing studies, and depending on the finding, by context-dependence (relevance) or uneven richness of supporting data (adequacy) (Lewin et al., 2015).”
From Relational and Institutional Disenfranchisement in Suicide Bereavement: A Qualitative Meta-Synthesis of Family Members' Experiences (2026) · cites this paper as Lewin et al., 2015
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredGRADE-CERQual was used to assess confidence in the evidence informing each individual review finding, with ratings of high, moderate, or low confidence.
“The Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach [37] was used to assess the confidence that can be attributed to the evidence informing each individual review finding, with ratings of high, moderate, or low confidence being attributed to each finding.”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [37]
Confidence in the evidence was assessed using the GRADE-CERQual approach.
“Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research approach.”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [37]
Confidence in the evidence was assessed using GRADE-CERQual and ranged from high to moderate.
“Confidence in the evidence was assessed using the GRADE-CERQual [37] tool and ranged from high to moderate (Multimedia Appendix 7 [9,14-16,44-52]).”
From Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: Systematic Review and Thematic Synthesis (2022) · cites this paper as [37]
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Cochrane Qualitative and Implementation Methods Group guidance series—paper 1: introduction
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Why do women consume alcohol during pregnancy or while breastfeeding?
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Self-citation
- Authors
- Lewin, S., Glenton, C., Munthe-Kaas, H., Carlsen, B., Colvin, C. J., Gülmezoglu, M., Noyes, J., Booth, A., Garside, R., & Rashidian, A.
- Affiliations
- South African Medical Research Council (ZA)
- Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
- Uni Research (Norway) (NO)
- University of Cape Town (ZA)
- World Bank (US)
- Bangor University (GB)
- University of Sheffield (GB)
- University of Exeter (GB)
- World Health Organization Regional Office for the Eastern Mediterranean (EG)
- Corresponding author
- Lewin, Simon
- ORCID
- Venue
- PLOS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-10-27
- Volume
- 12
- Issue
- 10
- Pages
- e1001895
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC4624425
- OpenAlex
- W2107819237
- Cited by
- 866
- References
- 48
- Citations by year
- 2026: 68 · 2025: 60 · 2024: 84 · 2023: 66 · 2022: 77 · 2021: 120 · 2020: 86 · 2019: 95 · 2018: 75 · 2017: 77 · 2016: 54 · 2015: 2 · 2014: 1 · 2013: 1
- FWCI
- 63.46
- Type
- journal article
- Language
- en
- Update notices
- correction (2016-06-10)
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bangor University Research Portal (Bangor University) (acceptedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Bergen Open Research Archive (BORA) (University of Bergen) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Figshare (submittedVersion)
- Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
- Bangor University Research Portal (Bangor University) (submittedVersion, other-oa)
- Funders
- World Health Organization
- South African Medical Research Council
- Alliance for Health Policy and Systems Research
- Medical Research Council
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Education › Qualitative Research Methods and Applications
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- qualitative evidence synthesis, GRADE-CERQual, decision-making, transparency, research evidence appraisal
- MeSH terms
- Decision Making, Humans, Public Policy, Research Design, Qualitative Research, Evidence-Based Practice
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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