AMSTAR 2
2026-04-27
As one of the key tools in evidence-based medicine, AMSTAR 2 can be used to evaluate systematic reviews that include randomized control trials (RCTs) and/or non-randomized studies of health care interventions (NRSIs). The original AMSTAR tool designed for RCTs was refined to include NRSIs. The resulting AMSTAR 2 tool expanded from 11 to 16 domains retaining 10 of the original domains while the 11th was integrated into another. The response categories are now more concise and are accompanied by a more comprehensive user guide. Overall ratings are based on weaknesses identified across critical domains.
We confirm having found domains to be common to all SRs (Summary of Progress report), but their appraisal may vary in detail according to the specific topic. The general domains include:
- Clear question Patient (Participant/Problem/Population), Intervention, Control (Comparator), Outcomes (PICO)
- Registration of protocol
- Specification of eligible study types
- Adequacy of scoping review
- Study selection and data extraction
- Lists of included/excluded studies
- Importance of potential conflicts of interest
- Investigation of heterogeneity and publication bias
The content-specific domains include:
- Risk of Bias (RoB) assessment of individual studies
- Appropriateness of statistical pooling methods
- Consideration of Impacts of risk of bias on synthesis and interpretation of data
