Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews

Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a check...

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Published in:	BMC medical research methodology Vol. 7; no. 1; p. 10
Main Authors:	Shea, Beverley J, Grimshaw, Jeremy M, Wells, George A, Boers, Maarten, Andersson, Neil, Hamel, Candyce, Porter, Ashley C, Tugwell, Peter, Moher, David, Bouter, Lex M
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 15-02-2007 BioMed Central BMC
Subjects:	Bias Factor Analysis, Statistical Humans Quality Control Reference Standards Reproducibility of Results Review Literature as Topic Surveys and Questionnaires
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Abstract	Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use.
AbstractList	Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use. BACKGROUND: Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. METHODS: A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. RESULTS: The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. CONCLUSION: A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use. Abstract Background Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. Methods A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. Results The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. Conclusion A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use. BACKGROUNDOur objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus.METHODSA 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity.RESULTSThe factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity.CONCLUSIONA measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use.
ArticleNumber	10
Author	Moher, David Bouter, Lex M Shea, Beverley J Wells, George A Hamel, Candyce Andersson, Neil Porter, Ashley C Tugwell, Peter Grimshaw, Jeremy M Boers, Maarten
AuthorAffiliation	4 Department of Clinical Epidemiology and Biostatistics. VU University Medical Center, Amsterdam, the Netherlands 5 Community Information and Epidemiological Technologies (CIETcanada), Ottawa, Ontario, Canada 2 Institute of Population Health, Ottawa, Ontario, Canada 3 Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada 1 EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands 6 University of Ottawa, Ottawa, Ontario, Canada
AuthorAffiliation_xml	– name: 2 Institute of Population Health, Ottawa, Ontario, Canada – name: 5 Community Information and Epidemiological Technologies (CIETcanada), Ottawa, Ontario, Canada – name: 3 Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada – name: 4 Department of Clinical Epidemiology and Biostatistics. VU University Medical Center, Amsterdam, the Netherlands – name: 1 EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands – name: 6 University of Ottawa, Ottawa, Ontario, Canada
Author_xml	– sequence: 1 givenname: Beverley J surname: Shea fullname: Shea, Beverley J email: bshea@ciet.org organization: EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. bshea@ciet.org – sequence: 2 givenname: Jeremy M surname: Grimshaw fullname: Grimshaw, Jeremy M – sequence: 3 givenname: George A surname: Wells fullname: Wells, George A – sequence: 4 givenname: Maarten surname: Boers fullname: Boers, Maarten – sequence: 5 givenname: Neil surname: Andersson fullname: Andersson, Neil – sequence: 6 givenname: Candyce surname: Hamel fullname: Hamel, Candyce – sequence: 7 givenname: Ashley C surname: Porter fullname: Porter, Ashley C – sequence: 8 givenname: Peter surname: Tugwell fullname: Tugwell, Peter – sequence: 9 givenname: David surname: Moher fullname: Moher, David – sequence: 10 givenname: Lex M surname: Bouter fullname: Bouter, Lex M
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/17302989$$D View this record in MEDLINE/PubMed
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References	B Shea (193_CR8) 2001 S Downs (193_CR24) 1998; 52 GR Norman (193_CR29) 2000 J Lau (193_CR2) 1998; 351 JM Stern (193_CR17) 1997; 315 B Pham (193_CR16) 2000 (193_CR34) 2005 JAC Sterne (193_CR18) 2000; 53 AP Verhagen (193_CR26) 1998; 51 M Egger (193_CR10) 1997; 350 D Moher (193_CR11) 2000; 53 B Shea (193_CR23) 1999 D Moher (193_CR22) 1999; 3 H Sacks (193_CR7) 1987; 316 DL Streiner (193_CR30) 2003 K Dickersin (193_CR13) 1990; 263 193_CR3 193_CR4 A Jadad (193_CR5) 2000; 320 AR Jadad (193_CR25) 1996; 17 193_CR9 A Sutton (193_CR19) 2000; 320 F Davidoff (193_CR1) 1995; 310 K Dickersin (193_CR14) 1997; 9 C Phillips (193_CR15) 2004; 4 S Hopewell (193_CR20) 2004 P Kline (193_CR28) 1994 I McDowell (193_CR31) 1996; 1 J Lau (193_CR33) 2006; 333 AD Oxman (193_CR6) 1994; 309 FA Cluzeau (193_CR27) 2001 L McAuley (193_CR21) 2000; 356 193_CR12 193_CR32
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SubjectTerms	Bias Factor Analysis, Statistical Humans Quality Control Reference Standards Reproducibility of Results Review Literature as Topic Surveys and Questionnaires
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Title	Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews
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