With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. AMSTAR was developed to evaluate systematic reviews of randomised trials. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. It is important that users can distinguish high quality reviews. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Correspondence to: B J Shea bevsheauottawa.ca.11Institute for Clinical Evaluative Sciences, Toronto, Canada.10Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.9Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia.8Centre for Research in Educational and Community Services, School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada.7Department of Medicine, The Ottawa Hospital, Ottawa, Canada.6The Hospital for Sick Children, the Genetics and Genome Biology Program, Toronto, Canada.5University of Ottawa Heart Institute, Ottawa, Canada.4School of Clinical Sciences, University of Bristol, Bristol, UK.
3School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
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