Abstract：
\'A Measurement Tool to Assess Systematic Reviews, version 2\' (AMSTAR 2) is a validated 16-item scale designed to appraise systematic reviews (SRs) of healthcare interventions and to rate the overall confidence in their results. This commentary aims to describe the challenges with rating of the individual items and the application of AMSTAR 2 from the user perspective.
A group of six experienced users (methodologists working in different clinical fields for at least 10 years) identified and discussed the challenges in rating of each item and the general use of AMSTAR 2 to appraise SRs. A group discussion was used to develop recommendations on how users could deal with the identified challenges. We identified various challenges with the content of items 2-16 and with the derivation of the overall confidence ratings on AMSTAR 2. These challenges include the need (1) to provide additional definitions (e.g., what constitutes major deviations from SR protocol on item 2), (2) to choose a rating strategy for multiple conditions on single items (e.g., how to rate item 5 if studies were selected in duplicate, but consensus between two authors was not reported), and (3) to determine rules for deriving the confidence ratings (e.g., what items are critical for such ratings). Based on these challenges we formulated specific recommendations for items 2-16 that AMSTAR 2 users could consider before applying the tool. Our commentary adds to the existing literature by providing the first in-depth examination of the AMSTAR 2 tool from the user perspective. The identified challenges could be addressed by additional decision rules including definitions for ambiguous items and guidance for rating of complex items and derivation of confidence ratings. We recommend that a team consensus regarding such decision rules is required before appraisal procedure begins.
Not applicable.
A group of six experienced users (methodologists working in different clinical fields for at least 10 years) identified and discussed the challenges in rating of each item and the general use of AMSTAR 2 to appraise SRs. A group discussion was used to develop recommendations on how users could deal with the identified challenges. We identified various challenges with the content of items 2-16 and with the derivation of the overall confidence ratings on AMSTAR 2. These challenges include the need (1) to provide additional definitions (e.g., what constitutes major deviations from SR protocol on item 2), (2) to choose a rating strategy for multiple conditions on single items (e.g., how to rate item 5 if studies were selected in duplicate, but consensus between two authors was not reported), and (3) to determine rules for deriving the confidence ratings (e.g., what items are critical for such ratings). Based on these challenges we formulated specific recommendations for items 2-16 that AMSTAR 2 users could consider before applying the tool. Our commentary adds to the existing literature by providing the first in-depth examination of the AMSTAR 2 tool from the user perspective. The identified challenges could be addressed by additional decision rules including definitions for ambiguous items and guidance for rating of complex items and derivation of confidence ratings. We recommend that a team consensus regarding such decision rules is required before appraisal procedure begins.
Not applicable.
摘要：
背景：\'评估系统评论的测量工具，版本2（AMSTAR2）是经过验证的16项量表，旨在评估医疗保健干预措施的系统评价（SRs）并对其结果进行总体信心评分。本评论旨在从用户的角度描述各个项目的评级和AMSTAR2的应用方面的挑战。
结论：一组六位有经验的使用者（在不同临床领域工作至少10年的方法学专家）确定并讨论了每个项目的评级和AMSTAR2评估SRs的一般使用方面的挑战。小组讨论用于就用户如何应对已确定的挑战提出建议。我们确定了项目2-16的内容以及AMSTAR2的总体置信度等级的推导的各种挑战。这些挑战包括需要(1)提供额外的定义(例如，什么构成了与SR协议第2项)的主要偏差，（2）在单个项目上选择多个条件的评级策略（例如，如果研究是一式两份选择的，如何对项目5进行评分，但没有报道两位作者之间的共识)，和(3)确定用于推导置信度等级的规则(例如，哪些项目对此类评级至关重要)。基于这些挑战，我们为项目2-16制定了具体建议，AMSTAR2用户可以在应用该工具之前考虑这些建议。我们的评论通过从用户的角度对AMSTAR2工具进行了首次深入检查，从而增加了现有文献。可以通过其他决策规则来解决所确定的挑战，包括对模糊项目的定义以及对复杂项目的评级和信心评级的推导的指导。我们建议在评估程序开始之前，需要就此类决策规则达成团队共识。
背景：不适用。
结论：一组六位有经验的使用者（在不同临床领域工作至少10年的方法学专家）确定并讨论了每个项目的评级和AMSTAR2评估SRs的一般使用方面的挑战。小组讨论用于就用户如何应对已确定的挑战提出建议。我们确定了项目2-16的内容以及AMSTAR2的总体置信度等级的推导的各种挑战。这些挑战包括需要(1)提供额外的定义(例如，什么构成了与SR协议第2项)的主要偏差，（2）在单个项目上选择多个条件的评级策略（例如，如果研究是一式两份选择的，如何对项目5进行评分，但没有报道两位作者之间的共识)，和(3)确定用于推导置信度等级的规则(例如，哪些项目对此类评级至关重要)。基于这些挑战，我们为项目2-16制定了具体建议，AMSTAR2用户可以在应用该工具之前考虑这些建议。我们的评论通过从用户的角度对AMSTAR2工具进行了首次深入检查，从而增加了现有文献。可以通过其他决策规则来解决所确定的挑战，包括对模糊项目的定义以及对复杂项目的评级和信心评级的推导的指导。我们建议在评估程序开始之前，需要就此类决策规则达成团队共识。
背景：不适用。
