Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK.
Implement Sci. 2018 Jan 25;13(Suppl 1):13. doi: 10.1186/s13012-017-0691-8.
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.
背景：GRADE-CERQual（评估、制定和评价推荐意见的分级-来自定性研究综述的证据信心）方法由 GRADE 工作组开发。该方法旨在支持在决策中使用定性证据综合的结果，包括指南制定和政策制定。CERQual 包括四个评估从定性研究综述中获得的结果的置信度的组成部分（也称为定性证据综合）：（1）方法学限制，（2）相关性，（3）一致性和（4）数据充分性。本文是一系列关于如何应用 CERQual 的指南的一部分，重点介绍 CERQual 的一致性组成部分。
方法：我们通过搜索文献来开发一致性组成部分，从相关研究社区收集反馈，并通过项目组会议达成共识。在同意当前的定义和应用原则之前，我们在几个定性证据综合中测试了 CERQual 一致性组成部分。
结果：在应用 CERQual 时，我们将一致性定义为主要研究数据与综合该数据的综述结果之间的契合度是否清晰和合理。在本文中，我们描述了一致性组成部分及其基本原理，并提供了在综述结果背景下评估一致性的指导，作为 CERQual 方法的一部分。该指南概述了评估一致性所需的信息、评估一致性所需采取的步骤以及一致性评估的示例。
结论：本文为综述作者和其他人员提供了在 CERQual 方法背景下进行一致性评估的指南。我们认为，当支持综述结果的数据相互矛盾、模糊或不完整，或者存在可以用来综合数据的竞争理论时，一致性可能受到威胁。我们预计 CERQual 方法及其各个组成部分将随着我们在实践中实施该方法的经验的增加而进一步发展。
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