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

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          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 .

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          Most cited references 53

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          The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

          Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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              Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.

               T Sipe,  D Rennie,  D Stroup (2000)
              Because of the pressure for timely, informed decisions in public health and clinical practice and the explosion of information in the scientific literature, research results must be synthesized. Meta-analyses are increasingly used to address this problem, and they often evaluate observational studies. A workshop was held in Atlanta, Ga, in April 1997, to examine the reporting of meta-analyses of observational studies and to make recommendations to aid authors, reviewers, editors, and readers. Twenty-seven participants were selected by a steering committee, based on expertise in clinical practice, trials, statistics, epidemiology, social sciences, and biomedical editing. Deliberations of the workshop were open to other interested scientists. Funding for this activity was provided by the Centers for Disease Control and Prevention. We conducted a systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies using MEDLINE, Educational Research Information Center (ERIC), PsycLIT, and the Current Index to Statistics. We also examined reference lists of the 32 studies retrieved and contacted experts in the field. Participants were assigned to small-group discussions on the subjects of bias, searching and abstracting, heterogeneity, study categorization, and statistical methods. From the material presented at the workshop, the authors developed a checklist summarizing recommendations for reporting meta-analyses of observational studies. The checklist and supporting evidence were circulated to all conference attendees and additional experts. All suggestions for revisions were addressed. The proposed checklist contains specifications for reporting of meta-analyses of observational studies in epidemiology, including background, search strategy, methods, results, discussion, and conclusion. Use of the checklist should improve the usefulness of meta-analyses for authors, reviewers, editors, readers, and decision makers. An evaluation plan is suggested and research areas are explored.
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                Author and article information

                Contributors
                Role: senior methodologist, clinical investigator, and adjunct professor
                Role: professor
                Role: director and professor
                Role: research associate
                Role: senior clinical research associate
                Role: research student
                Role: senior scientist, associate professor, and university research chair
                Role: senior scientist and professor
                Role: clinical investigator and assistant professor
                Role: professor
                Role: professor and senior scientist
                Journal
                BMJ
                BMJ
                BMJ-UK
                bmj
                The BMJ
                BMJ Publishing Group Ltd.
                0959-8138
                1756-1833
                2017
                21 September 2017
                : 358
                Affiliations
                [1 ]Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
                [2 ]Bruyère Research Institute, Ottawa, Canada
                [3 ]School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
                [4 ]School of Clinical Sciences, University of Bristol, Bristol, UK
                [5 ]University of Ottawa Heart Institute, Ottawa, Canada
                [6 ]The Hospital for Sick Children, the Genetics and Genome Biology Program, Toronto, Canada
                [7 ]Department of Medicine, The Ottawa Hospital, Ottawa, Canada
                [8 ]Centre for Research in Educational and Community Services, School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
                [9 ]Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia;
                [10 ]Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
                [11 ]Institute for Clinical Evaluative Sciences, Toronto, Canada
                Author notes
                Correspondence to: B J Shea bevshea@ 123456uottawa.ca
                Article
                sheb036104
                10.1136/bmj.j4008
                5833365
                28935701
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.

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                Categories
                Research Methods & Reporting

                Medicine

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