Evidence map›Paper›PMID 29384081›Full record

ArticleImplementation science : IS2018

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

Christopher J Colvin, Ruth Garside, Megan Wainwright, Heather Munthe-Kaas, Claire Glenton, Meghan A Bohren, Benedicte Carlsen, Özge Tunçalp, Jane Noyes, Andrew Booth and 3 more

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In one paragraph

Article in Implementation science : IS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 64 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
129citing papers in PubMed, 64 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

129 citing papers in PubMed, 64 syntheses or guidelines pooled it.

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  3. Patients' experiences with musculoskeletal spinal pain: a qualitative systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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  17. Examining the lived experience of dementia with Lewy bodies through qualitative research: A systematic review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
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69 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Christopher J ColvinDivision of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Ruth GarsideEuropean Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK.
Megan WainwrightDivision of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Heather Munthe-KaasNorwegian Institute of Public Health, Oslo, Norway. heather.munthe-kaas@fhi.no.
Claire GlentonNorwegian Institute of Public Health, Oslo, Norway.
Meghan A BohrenUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland.
Benedicte CarlsenUni Research Rokkan Centre, Bergen, Norway.
Özge TunçalpUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland.
Jane NoyesSchool of Social Sciences, Bangor University, Bangor, UK.
Andrew BoothSchool of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
Arash RashidianDepartment of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Signe FlottorpNorwegian Institute of Public Health, Oslo, Norway.
Simon LewinNorwegian Institute of Public Health, Oslo, Norway.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundThe 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.

methodsWe 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.

resultsWhen 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.

conclusionsThis 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.

Indexed as

Data AccuracyData AnalysisSystematic Reviews as TopicBiomedical ResearchConfidence IntervalsDecision MakingEvidence-Based MedicineHumansPublishingQualitative ResearchCoherenceConfidenceEvidence-based practiceGRADEGuidanceMethodologyQualitative evidence synthesisQualitative researchResearch designSystematic review methodology

Identifiers

PMID29384081
PMCPMC5791039

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.