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Table 1 A MeaSurement Tool to Assess Reviews (AMSTAR), 2005 (from COMPUS [19])

From: Improving the use of research evidence in guideline development: 8. Synthesis and presentation of evidence

1. Was an 'a priori' design provided?
The research question and inclusion criteria should be established before the conduct of the review.
   Yes
   No
   Can't answer
   Not applicable
2. Were there duplicate study selection and data extraction?
There should be at least two independent data extractors and the consensus procedure for disagreements should be reported.
   Yes
   No
   Can't answer
   Not applicable
3. Was a comprehensive literature search performed?
At least two electronic sources should be searched. The report must include years and databases (e.g., Central, EPOC, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.
   Yes
   No
   Can't answer
   Not applicable
4. Was the status of publication (i.e., grey literature) used as an exclusion criterion?
The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status.
   Yes
   No
   Can't answer
   Not applicable
5. Was a list of studies (included and excluded) provided?
A list of included and excluded studies should be provided.
   Yes
   No
   Can't answer
   Not applicable
6. Were the characteristics of the included studies provided?
In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed (e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases) should be reported.
   Yes
   No
   Can't answer
   Not applicable
7. Was the scientific quality of the included studies assessed and reported?
'A priori' methods of assessment should be reported (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.
   Yes
   No
   Can't answer
   Not applicable
8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.
   Yes
   No
   Can't answer
   Not applicable
9. Were the methods used to combine the findings of studies appropriate?
For the pooled results, a test should be done to ensure the studies were combinable, to assess the homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists, random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).
   Yes
   No
   Can't answer
   Not applicable
10. Was the likelihood of publication bias assessed?
An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot) and statistical tests (e.g., Egger regression test).
   Yes
   No
   Can't answer
   Not applicable
11. Was the conflict of interest stated?
Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.
   Yes
   No
   Can't answer
   Not applicable
  1. Source: AMSTAR 2005 (Beverley Shea, CIET, Institute of Population Health, Ottawa: personal communication, 2005 Oct)