Carole Lunny, Nityanand Jain, Tina Nazari, Melodi Kosaner-Kließ, Lucas Santos, Ian Goodman, Alaa AM Osman, Stefano Berrone, Mohammad Dadam, Connor Brenna, Heba Hussein, Gioia Dahdal, Diana Cespedes A., Nicola Ferri, Salmaan Kanji, Yuan Chi, Dawid Pieper, Beverly Shea, Amanda Parker, Dipika Neupane, Paul Khan, Daniella Rangira, Kat Kolaski, Ben Ridley, Amina Berour, Kevin Sun, Radin Hamidi Rad, Zihui Ouyang, Emma K Reid, Iván Pérez-Neri, Sanabel Barakat, Silvia Bargeri, Silvia Gianola, Greta Castellini, Sera Whitelaw, Adrienne Stevens, Shailesh Kolekar, E. Bagheri, Kristy Wong, Paityn Major, Andrea Tricco
Research Synthesis Methods
Abstract
Background: AMSTAR-2 and ROBIS are tools used to assess the methodological quality and the risk of bias in systematic review (SRs). Methods: We applied AMSTAR-2 and ROBIS to a sample of 200 published SRs. We investigated the overlap in their methodological constructs, responses by item and overall, percentage agreement, direction of effect, and timing of assessments. Results: AMSTAR-2 contains 16 items and ROBIS contains 24 items. Three items in AMSTAR-2 and nine items in ROBIS did not overlap in construct. Of the 200 SRs, 73% were low or critically low quality using AMSTAR-2 and 81% had high risk of bias using ROBIS. The median time to complete AMSTAR-2 and ROBIS was 51 and 64 minutes, respectively. When assessment times were calibrated to the number of items in each tool, each item took on average of 3.2 minutes for AMSTAR-2 compared to 2.7 minutes for ROBIS. Nine percent of SRs had opposed ratings (i.e., AMSTAR-2 was high quality while ROBIS was high risk). In both tools, three-quarters of items showed more than 70% agreement between senior and junior raters after extensive training and piloting. Conclusions: The tools are not exchangeable due to their unique items and differences in underlying concepts. While AMSTAR-2 only considers the methodological quality of the results, ROBIS considers the bias in the results and conclusions. Additionally, ROBIS invites reviewers to assess the external validity, which is absent from AMSTAR-2. AMSTAR-2 may be more appropriate where faster assessments are prioritised. ROBIS may be more appropriate when a comprehensive bias assessment is sought.