Applying CERQual to findings from a qualitative evidence synthesis on user perceptions of mHealth: discussing methodological challenges

Session: 

Oral session: Qualitative evidence synthesis methodology

Date: 

Sunday 16 September 2018 - 14:00 to 14:20

Location: 

Carrick 2

All authors in correct order:

Ames H1, Lewin S2, Glenton C1, Leon N3
1 Norwegian Institute of Public Health, Norway
2 South African Medical Research Council/Norwegian Institute of Public Health, Norway
3 South African Medical Research Council, South Africa
Presenting author and contact person

Presenting author:

Heather Ames

Contact person:

Heather Ames
Abstract text
Background: Assessing how much confidence to place in findings from qualitative evidence syntheses (QES) using the GRADE-CERQual approach is a relatively new approach, and the way in which the four components are assessed and applied may vary across evidence synthesis teams. Reflecting on how challenges were addressed in CERQual application contributes to further development of this innovative methodology.

Objectives: We will first provide a worked example from applying CERQual to findings from a QES on user perceptions of mHealth in order to illustrate the methodological challenges we faced and how we resolved them. Secondly, we will reflect on how the challenges we addressed can contribute to the further development of the CERQual methodology.

Methods: We applied the four CERQual components to assess the confidence we had in the findings from our qualitative evidence synthesis.

Results: We will present and discuss a number of issues that arose during our application of CERQual. These include: the order in which the assessments should be made; issues related to partial relevance due to study setting; methodological limitations due to poor description of researcher reflexivity; debate around how to word findings and when to split or lump them; and questions surrounding data adequacy and coherence.

Conclusions: Using CERQual to assess the confidence in the findings from the QES allowed us transparently and systematically to assess our confidence in each of our review findings. However, this required ongoing debate within the review team, and addressing some challenges in the CERQUal application, in order to reach consensus. Reflecting on the challenges of applying CERQual in practice can assist others in their application and could lead to further sharpening of the methodology in future.

Patient or healthcare consumer involvement: Patients and consumers were not directly involved in the qualitative evidence synthesis. However, we consider the individual studies that we will include in the review as a systematic attempt to represent the consumer voice.

Relevance to patients and consumers: 

Patients and consumers were not directly involved in the qualitative evidence synthesis. However, we consider the individual studies that we will include in the review as a systematic attempt to represent the consumer voice. The sampling framework we used ensured that voices from all available settings were included.