Psychometric measurements of AMSTAR 2 in a sample of meta-analyses indexed in PsycINFO

Leclercq, Victoria; Beaudart, Charlotte; Tirelli, Ezio; Bruyère, Olivier

doi:10.1016/j.jclinepi.2019.10.005

Cited by 26 publications

(27 citation statements)

References 4 publications

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“…Our results revealed that the methodological rigour of recent acupuncture SRs is weak, with more than 93% being critically low-quality. The observation that the majority of the SRs are of critically low-quality resembles findings from a similar study [ 32 ], and the floor effect caused by high standards set by the AMSTAR 2 might be an explanation. Nevertheless, such poor ratings also reflect a real need in improving SR methodology in this field [ 33 ], as only high-quality SRs should be used for guiding decision-making.…”

Section: Discussionsupporting

confidence: 78%

Low methodological quality of systematic reviews on acupuncture: a cross-sectional study

Wong

et al. 2021

BMC Med Res Methodol

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Background While well-conducted systematic reviews (SRs) can provide the best evidence on the potential effectiveness of acupuncture, limitations on the methodological rigour of SRs may impact the trustworthiness of their conclusions. This cross-sectional study aimed to evaluate the methodological quality of a representative sample of SRs on acupuncture effectiveness. Methods Cochrane Database of Systematic Reviews, MEDLINE, and EMBASE were searched for SRs focusing on the treatment effect of manual acupuncture or electro-acupuncture published during January 2018 and March 2020. Eligible SRs must contain at least one meta-analysis and be published in English language. Two independent reviewers extracted the bibliographical characteristics of the included SRs with a pre-designed questionnaire and appraised the methodological quality of the studies with the validated AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2). The associations between bibliographical characteristics and methodological quality ratings were explored using Kruskal-Wallis rank tests and Spearman’s rank correlation coefficients. Results A total of 106 SRs were appraised. Only one (0.9%) SR was of high overall methodological quality, zero (0%) was of moderate-quality, six (5.7%) and 99 (93.4%) were of low-quality and critically low-quality respectively. Among appraised SRs, only ten (9.4%) provided an a priori protocol, four (3.8%) conducted a comprehensive literature search, five (4.7%) provided a list of excluded studies, and six (5.7%) performed meta-analysis appropriately. Cochrane SRs, updated SRs, and SRs that did not search non-English databases had relatively higher overall quality. Conclusions Methodological quality of SRs on acupuncture is unsatisfactory. Future reviewers should improve critical methodological aspects of publishing protocols, performing comprehensive search, providing a list of excluded studies with justifications for exclusion, and conducting appropriate meta-analyses. These recommendations can be implemented via enhancing the technical competency of reviewers in SR methodology through established education approaches as well as quality gatekeeping by journal editors and reviewers. Finally, for evidence users, skills in SR critical appraisal remain to be essential as relevant evidence may not be available in pre-appraised formats.

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Section: Discussionsupporting

confidence: 78%

Low methodological quality of systematic reviews on acupuncture: a cross-sectional study

Wong

et al. 2021

BMC Med Res Methodol

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“…In psychology, AMSTAR-2 had a profound floor effect, 95% rating critically low. 43 The quality of the primary articles in our review, however, was rated moderate to high, while findings were consistent with the systematic reviews supporting an explanation that the tools do not fit the purpose of our review on moral considerations.…”

Section: Strengths and Limitationssupporting

confidence: 72%

Which moral barriers and facilitators do physicians encounter in advance care planning conversations about the end of life of persons with dementia? A meta-review of systematic reviews and primary studies

et al. 2020

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Importance and objectiveConducting advance care planning (ACP) conversations with people with dementia and their relatives contributes to providing care according to their preferences. In this review, we identify moral considerations which may hinder or facilitate physicians in conducting ACP in dementia.DesignFor this meta-review of systematic reviews and primary studies, we searched the PubMed, Web of Science and PsycINFO databases between 2005 and 30 August 2019. We included empirical studies concerning physicians’ moral barriers and facilitators of conversations about end-of-life preferences in dementia care. The protocol was registered at Prospero (CRD42019123308).Setting and participantsPhysicians and nurse practitioners providing medical care to people with dementia in long-term and primary care settings. We also include observations from patients or family caregivers witnessing physicians’ moral considerations.Main outcomesPhysicians’ moral considerations involving ethical dilemmas for ACP. We define moral considerations as the weighing by the professional caregiver of values and norms aimed at providing good care that promotes the fundamental interests of the people involved and which possibly ensues dilemmas.ResultsOf 1347 studies, we assessed 22 systematic reviews and 51 primary studies as full texts. We included 11 systematic reviews and 13 primary studies. Themes included: (1) beneficence and non-maleficence; (2) respecting dignity; (3) responsibility and ownership; (4) relationship and (5) courage. Moral dilemmas related to the physician as a professional and as a person. For most themes, there were considerations that either facilitated or hindered ACP, depending on physician’s interpretation or the context.ConclusionsPhysicians feel a responsibility to provide high-quality end-of-life care to patients with dementia. However, the moral dilemmas this may involve, can lead to avoidant behaviour concerning ACP. If these dilemmas are not recognised, discussed and taken into account, implementation of ACP as a process between physicians, persons with dementia and their family caregivers may fail.

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“…In our study we observe a possible floor effect (53 of 60 reviews were rated as critically low). Leclercq et al. (2020) found something similar and criticized that AMSTAR 2 is lacking discriminating capacity.…”

Section: Discussionmentioning

confidence: 99%

The methodological quality of systematic reviews on the treatment of adult major depression needs improvement according to AMSTAR 2: A cross-sectional study

Matthias

Rissling

Pieper

et al. 2020

Heliyon

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Background Several standards have been developed to assess methodological quality of systematic reviews (SR). One widely used tool is the AMSTAR. A recent update - AMSTAR 2 - is a 16 item evaluation tool that enables a detailed assessment of SR that include randomised (RCT) or non-randomised studies (NRS) of healthcare interventions. Methods A cross-sectional study of SR on pharmacological or psychological interventions in major depression in adults was conducted. SR published during 2012–2017 were sampled from MEDLINE, EMBASE and the Cochrane Database of SR. Methodological quality was assessed using AMSTAR 2. Potential predictive factors associated with quality were examined. Results In rating overall confidence in the results of 60 SR four reviews were rated “high”, two were “moderate”, one was “low” and 53 were “critically low”. The mean AMSTAR 2 percentage score was 45.3% (standard deviation 22.6%) in a wide range from 7.1% to 93.8%. Predictors of higher quality were: type of review (higher quality in Cochrane Reviews), SR including only randomized trials and higher journal impact factor. Limitations AMSTAR 2 is not intended to be used for the generation of a percentage score. Conclusions According to AMSTAR 2 the overall methodological quality of SR on the treatment of adult major depression needs improvement. Although there is a high need for summarized information in the field of mental health, this work demonstrates the need to critically assess SR before using their findings. Better adherence to established reporting guidelines for SR is needed.

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Psychometric measurements of AMSTAR 2 in a sample of meta-analyses indexed in PsycINFO

Cited by 26 publications

References 4 publications

Low methodological quality of systematic reviews on acupuncture: a cross-sectional study

Low methodological quality of systematic reviews on acupuncture: a cross-sectional study

Which moral barriers and facilitators do physicians encounter in advance care planning conversations about the end of life of persons with dementia? A meta-review of systematic reviews and primary studies

The methodological quality of systematic reviews on the treatment of adult major depression needs improvement according to AMSTAR 2: A cross-sectional study

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