Key result
Study evaluates AMSTAR 2 high-quality ratings for predicting systematic error in systematic reviews.
Why the study?
The study was designed to investigate the likelihood that systematic reviews rated as high-quality using the AMSTAR 2 tool are affected by high risk of systematic error.
This protocol outlines a methodological study to investigate whether systematic reviews rated as 'high-quality' by the AMSTAR 2 tool are actually free from high risk of systematic error.
Clinicians should interpret AMSTAR 2 high-quality ratings cautiously; this protocol leaves open their accuracy against high systematic error risk.
Aim: To investigate the likelihood that systematic reviews with “high-quality” AMSTAR 2 rating are affected by high risk of systematic error (bias). Methods: A systematic literature search of current meta-reviews (systematic reviews of systematic reviews) will be conducted. From the identified meta-reviews, systematic reviews with “high” and “low” or “critically low” AMSTAR 2 quality rating will be extracted. All meta-analysis of the systematic reviews will be statistically tested for selection bias and the reviewed trials re-appraised for bias risk using the CQS-2B tool. From the test and re-appraisal results true positive, true negative, false positive or false negative results will be established and the negative and positive likelihood ratios with 95% Confidence interval computed. From the likelihood ratios the likelihood that systematic reviews with “high-quality” AMSTAR 2 rating are affected by high risk of systematic error will be inferred. Ethics and dissemination: Ethical approval is not required for methodological studies. The results will be disseminated as a prior preprint version and subsequent peer-reviewed publication.
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Mickenautsch et al. (2023) studied Systematic reviews of prospective, controlled, clinical therapy trials. AMSTAR 2 tool was evaluated on Negative likelihood ratio (-LR) of systematic reviews with 'high' confidence AMSTAR 2 rating yielding a negative statistical test result for selection bias. The AMSTAR 2 tool's 'high-quality' rating accuracy will be evaluated to determine the likelihood that systematic reviews with this rating are affected by a high risk of systematic error.
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