Appraisal methods and outcomes of AMSTAR 2 assessments in overviews of systematic reviews of interventions in the cardiovascular field: A methodological study

Ref ID 1026
First Author P. Karakasis
Journal RESEARCH SYNTHESIS METHODS
Year Of Publishing 2024
URL https://onlinelibrary.wiley.com/doi/10.1002/jrsm.1680
Keywords • Cardiology
• Overviews/Umbrella Reviews
Problem(s) • Low methodological (AMSTAR) quality
• Cochrane reviews more rigorous/higher quality than non-Cochrane reviews
• Lack of guidance or consistency in systematic overview / umbrella / review of systematic reviews
Article Type Empirical
Article Subtype Cross-sectional survey/Methodological systematic review
First Author Country Greece
Checklists • AMSTAR 2
Aim To (1) describe the epidemiological characteristics of overviews of interventions in the cardiovascular field that applied AMSTAR 2 for the critical appraisal of the included SRs or MAs, (2) assess the methods for deriving or computing of the overall confidence ratings and outcomes of AMSTAR 2 appraisals in these overviews, (3) identify factors that are potentially associated with these ratings, (4) contrast the assessments provided by overview authors, namely original ratings or assessments, to the results derived by the official AMSTAR 2 online tool, and (5) provide recommendations for AMSTAR 2 appraisals in overviews and improve the interpretation of confidence ratings.
Level of Investigation Descriptive
Summary of Findings From 679 systematic reviews indexed across MEDLINE, Scopus, and the Cochrane Database of Systematic Reviews until November 2022. More than half (53% (360/679)) of the systematic reviews (SRs) of interventions included in 34 cardiovascular overviews assessed were of “Critically low” confidence according to AMSTAR 2. Heterogeneity is observed in the rating algorithms used by overviews' authors to derive the overall confidence in SRs in the cardiovascular field. Rating of the overall confidence presented in four categories and derived based on the seven critical and nine non- critical items was noted in 74% (25/34), whereas in 9% (3/34) of overviews ratings were derived based on overall score. About half authors did not provide an explicit statement of the rating method but tersely reported that SRs' assessment would be conducted with the AMSTAR 2 tool. Furthermore, only a minority of authors described their own algorithm for rating overall confidence (18%; 6/34). The following characteristics of SRs were significantly associated with higher overall ratings: Cochrane origin, pharmacological interventions, including exclusively RCTs, citation of methodological and reporting guidelines, protocol, absence of funding and publication after AMSTAR 2 release.
Number of systematic reviews included 679
Number of eligible systematic reviews assessed 2567
Treatment impacted No
Treatment impacted description
Interpretation impacted Not Applicable
Interpretation impacted description