Background: The ConQual approach for the assessment of the confidence in synthesised qualitative research findings in systematic reviews of qualitative evidence was proposed for the Joanna Briggs Institute’s meta-synthesis by meta-aggregation, and the GRADE Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach for assessing confidence in qualitative evidence syntheses findings was designed for syntheses of qualitative evidence.
Objectives: To provide a principled and pragmatic critique of the ConQual and GRADE-CERQual approaches and offer suggestions for their improvement.
Methods: Assessment of ConQual and GRADE-CERQual approaches informed by a critical review of the methodological literature on the quality criteria used in qualitative research and on the conduct of systematic reviews of qualitative research, and by insights from hermeneutics and American pragmatism philosophy.
Results: Potentially serious flaws may be evident in both the ConQual and GRADE-CERQual approaches when evaluated critically from theoretical, philosophical, and practical perspectives. These flaws appear to be related to the conceptualisation of the nature of confidence in qualitative research and of the aim of establishing confidence in synthesised findings in syntheses of qualitative research, the selection of criteria for establishing confidence, the justification provided for these criteria, and the operationalisation of the criteria.
Conclusions: Based upon our assessment, we suggest that both ConQual and GRADE-CERQual should be revised. We provide suggestions for correcting the identified flaws.