3.3.15 Assessment of confidence of qualitative synthesised findings
- Carolyn Phillips
Analytics
The explicit aim of meta-aggregation is to ensure that the synthesised findings can be used to make recommendations for healthcare practice or inform policy. Therefore, along with assessing the methodological quality of included studies, assessing the confidence in the synthesised findings is a critical step in meta-aggregation.
The ConQual approach is specifically designed to evaluate the confidence of synthesised findings through meta-aggregation (Munn et al. 2014). While other methods such as CERQual (Lewin et al. 2018) exist for assessing the confidence of qualitative evidence synthesis findings, their applicability to reviews using meta-aggregation has not yet been explored. As a result, the JBI Qualitative Methodology Group currently recommends using ConQual for qualitative evidence synthesis via meta-aggregation. Full details and guidance on the ConQual approach are available in an associated publication (Munn et al. 2014). While the ConQual approach provides criteria for assessing unequivocal, credible, and unsupported findings, only unequivocal and credible findings should be included in the synthesised results.
Presenting the information in a ConQual Summary of Findings table is recommended. The following information should be included, with due consideration to equity issues, to ensure transparency.
Title: State the title of the systematic review.
Bibliography: Cite the bibliographic reference of the systematic review.
Population: Describe the population group.
Phenomenon of interest: Describe the phenomenon of interest.
Context: Provide sufficient description of the context or any contextual considerations.
Synthesised findings: State the synthesised finding.
Types of research.
Dependability: For each synthesised finding, provide an assessment of dependability.
Credibility: For each synthesised finding, provide an assessment of credibility.
Overall ConQual score: For each synthesised finding, provide a ConQual score.
Comments: Provide any comments.
Table 3: Example of a ConQual Summary of Findings table (cited in Allen & Vottero 2020)
Title: Homeless women’s experiences is accessing health care in community-based settings: a qualitative systematic review | ||||
Bibliography: Allen J, Voero B. Experiences of homeless women in accessing health care in community-based settings: a qualitative systematic review. JBI Evid Synth 2020;18(9):1970–2010. | ||||
Population: Homeless women, both previously or currently, aged 18 or older | ||||
Phenomenon of interest: women’s experiences in accessing health care, including their perspectives, narratives and/or reflections, at any time during their period of homelessness | ||||
Context: Health care interactions between health care providers and homeless women in community-based settings, shelter-based clinics and/or mobile clinics | ||||
Synthesised finding | Type of research | Dependability | Credibility | ConQual score |
Homeless women who access health care services at community based settings feel as if their homelessness qualifies them as second-class citizens which impedes future access | Qualitative | Downgrade 1 level* | Downgrade 1 level** | Low |
Homeless women have an expectations of therapeutic communications from their health care providers, the lack of which can incite negative emotional responses, fear, and knowledge deficits | Qualitative | Downgrade 1 level* | Downgrade 1 level** | Low |
Homeless women with limited resources struggle to prioritize competing needs, such as transportation, time and money, which influences their ability to access health care | Qualitative | Downgrade 1 level* | Downgrade 1 level** | Low |
* Downgraded one level due to common dependability issues across the included primary studies (the majority of
studies had no statement locating the researcher and no acknowledgement of their influence on the research).
** Downgraded one level due to a mix of unequivocal and credible findings.