There are many approaches to synthesis of qualitative studies. The GRADE-CERQual approach (Confidence in the Evidence from Reviews of Qualitative research) provides a transparent method for assessing the confidence of evidence from reviews of qualitative research. This presentation aims at giving examples of applying CERQual, presenting and discussing its strengths and limitations.

This presentation draws on practical experiences with the conduction of three qualitative systematic reviews using the CERQual approach. The reviews differ in aim and field of research.

The three CERQual reviews to be discussed in this presentation are: (i) Emergency departments and mental health patients - Purpose: Uncovering knowledge in a project on merging emergency departments to include both somatic and psychiatric patients. (ii) Parental responses to severe or lethal prenatal diagnosis – Purpose: Providing physicians with knowledge on a patient group from their daily clinical practice. (iii) Patients' experiences with home mechanical ventilation – Purpose: Disseminating important knowledge from a national project to an international audience.

CERQual strengths:

• • Presents complex and large amount of knowledge in a clear way

• • Pools knowledge from different studies into common outcome measures across studies

• • Presents an assessment of the quality and strength of outcome measures

• • The clear presentation makes it useful in decision making.

CERQual weaknesses:

• • Time consuming to conduct the reviews

• • Simplification of qualitative research, missing out on context and nuances.

CERQual represents a useful tool to facilitate the use of qualitative evidence in clinical and political decision making. CERQual is time-consuming to learn, but a useful tool to apply when learned. CERQual may encourage more uniform reporting of qualitative research, including assessment of confidence in findings. This may increase the impact of systematic reviews of qualitative studies.