Quality and Confidence Assessment

Included studies are appraised with the CASP Qualitative Checklist. GRADE-CERQual assesses confidence in qualitative review findings across methodological limitations, coherence, adequacy, and relevance. Study quality appraisal informs interpretation but does not exclude studies by itself. GRADE-CERQual findings start at high confidence and are downgraded when important concerns exist. CASP ratings are accompanied by narrative justification for each domain.