Systems for assessing the certainty or confidence of evidence in healthcare: a scoping review protocol.

Objective: This scoping review aims to identify existing systems, frameworks, and approaches for assessing certainty or confidence in quantitative, qualitative, and mixed methods evidence, providing a foundation for developing a unified framework tailored to mixed methods reviews.

Introduction: Assessing the certainty or confidence in evidence is essential for developing health care recommendations, yet current frameworks are often limited to either quantitative or qualitative paradigms. With the rise of mixed methods research, which integrates quantitative and qualitative evidence to address complex health care questions, there is a growing need for systems capable of evaluating certainty across these diverse evidence types.

Inclusion criteria: This scoping review will include systems, frameworks, or approaches explicitly developed to assess the certainty or confidence in evidence from quantitative, qualitative, or mixed methods studies. Eligible papers must describe the methodology, criteria, or principles of these systems or discuss their development, validation, or theoretical foundations. Systems focused solely on critical appraisal or quality assessment of individual studies will be excluded unless they integrate these assessments into a broader framework for assessing certainty in a body of evidence.

Methods: This review will be conducted in accordance with the JBI methodology for scoping reviews and reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A comprehensive 3-step search strategy will identify published, unpublished, and gray literature from databases, organizational websites, and reference lists. Data will be extracted using a piloted extraction table and presented in tables, figures, and a narrative summary to map existing systems, frameworks, or approaches for assessing certainty or confidence in evidence.

Review registration: Open Science Framework: osf.io/36n78.