AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both

• Published in: BMJ (Online) Vol. 358; p. j4008
• Main Authors: Shea, Beverley J, Reeves, Barnaby C, Wells, George, Thuku, Micere, Hamel, Candyce, Moran, Julian, Moher, David, Tugwell, Peter, Welch, Vivian, Kristjansson, Elizabeth, Henry, David A
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 21.09.2017; BMJ Publishing Group LTD; BMJ Publishing Group Ltd
• Subjects: Bias; Clinical Studies as Topic; Clinical trials; Design; Epidemiology; Evidence-Based Medicine; Meta-analysis; Meta-Analysis as Topic; Observational Studies as Topic; Observer Variation; Quality; Randomized Controlled Trials as Topic; Research Methods & Reporting; Review Literature as Topic; Reviews; Systematic review
• ISSN: 0959-8138; 1756-1833; 1756-1833
• DOI: 10.1136/bmj.j4008

The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.