Making better use of qualitative evidence in decision making

Cape Town | A series of seven papers recently published by Implementation Science describes an approach that helps researchers to make judgements about how much confidence to place in qualitative evidence use to inform decisions about health interventions and policies.  The GRADE-CERQual (‘Confidence in the Evidence from Reviews of Qualitative research’) approach is already being used in guidelines published by the World Health Organisation (WHO), the National Institute for Health and Care Excellence in the United Kingdom, the Swedish Council on Health Technology Assessment and the European Commission Initiative on Breast Cancer. 

“This series provides CERQual users with detailed information on how to apply the approach”, says Simon Lewin, Co-Author of the series and Specialist Scientist in the Health Systems Research Unit of the South African Medical Research Council (SAMRC).  “Decision makers equipped with the approach will be able to use qualitative evidence more appropriately”, Lewin concludes. 

The series is intended primarily for researchers undertaking qualitative evidence syntheses and for decision makers using the findings from these syntheses in decision-making processes. However, it is also relevant to guideline development agencies, primary qualitative researchers and implementation scientists and practitioners.  The series of papers is organised as follows:

 Paper 1 An overview of CERQual’s rationale and conceptual basis, how the approach was developed, and its aims and its main components. 
Paper 2 Discusses how to make an overall assessment of confidence in a review finding and how to create a Summary of Qualitative Findings table.
Papers 3, 4, 5, 6 & 7 Discusses each CERQual component, including how the component is conceptualised and how it should be assessed.

Guide to the GRADE-CERQual series of papers


“The importance of qualitative data is increasingly recognized when producing recommendations in public health, as these recommendations must reflect far more than the balance of benefits and harms of an intervention as measured quantitatively. Data on acceptability and feasibility, for example, are invaluable when formulating recommendations and when adapting them to the local context.  The CERQual approach has been vital in helping us to use qualitative evidence appropriately”, says Dr Susan L Norris, Secretary of the WHO Guidelines Review Committee. 

Part of the international GRADE Working Group
CERQual has been developed by an international team of qualitative researchers, as a subgroup of the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) Working Group ( with funding from the Alliance for Health Policy and Systems Research, Cochrane, Norad, the Research Council of Norway and WHO. Co-author Claire Glenton from the Norwegian Institute of Public Health notes: “We encourage those keen to support the further development of this approach to join the CERQual  Group via our website (”

About the South African Medical Research Council (SAMRC):
The scope of the SAMRC’s research includes basic laboratory investigations, clinical research and public health studies. Research at the SAMRC focuses on the following top 10 causes ( ) of death in South Africa.  To assist with delivering on this vital mandate, the organisation is led by the National Department of Health, and works with other key stakeholders such as the Department of Science and Technology, South African and international science councils, medical schools, universities, research institutions and international collaborators.


Release date: 
Friday, February 2, 2018 - 08:00
Dr Alfred Thutloa
Contact: Dr Alfred Thutloa

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