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Applying GRADE-CERQual to qualitative evidence synthesis findings—paper 5: how to assess adequacy of data

Glenton, Claire; Carlsen, Benedicte; Lewin, Simon; Munthe-Kaas, Heather; Colvin, Christopher J.; Tunçalp, Özge; Bohren, Meghan A.; Noyes, Jane; Booth, Andrew; Garside, Ruth; Rashidian, Arash; Flottorp, Signe; Wainwright, Megan

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Claire Glenton

Benedicte Carlsen

Simon Lewin

Heather Munthe-Kaas

Christopher J. Colvin

Özge Tunçalp

Meghan A. Bohren

Jane Noyes

Andrew Booth

Ruth Garside

Arash Rashidian

Signe Flottorp


Background: The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) 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) coherence; (3) adequacy of data; and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual’s adequacy of data component. Methods: We developed the adequacy of data component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual adequacy of data component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. Results: When applying CERQual, we define adequacy of data as an overall determination of the degree of richness and the quantity of data supporting a review finding. In this paper, we describe the adequacy component and its rationale and offer guidance on how to assess data adequacy in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess data adequacy, the steps that need to be taken to assess data adequacy, and examples of adequacy assessments. Conclusions: This paper provides guidance for review authors and others on undertaking an assessment of adequacy in the context of the CERQual approach. We approach assessments of data adequacy in terms of the richness and quantity of the data supporting each review finding, but do not offer fixed rules regarding what constitutes sufficiently rich data or an adequate quantity of data. Instead, we recommend that this assessment is made in relation to the nature of the finding. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.


Glenton, C., Carlsen, B., Lewin, S., Munthe-Kaas, H., Colvin, C. J., Tunçalp, Ö., …Wainwright, M. (2018). Applying GRADE-CERQual to qualitative evidence synthesis findings—paper 5: how to assess adequacy of data. Implementation Science, 13(S1), Article 14.

Journal Article Type Article
Online Publication Date Jan 25, 2018
Publication Date Jan 25, 2018
Deposit Date May 8, 2018
Publicly Available Date May 9, 2018
Journal Implementation Science
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 13
Issue S1
Article Number 14


Published Journal Article (944 Kb)

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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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