Table 2.
Percentage of reviews that satisfactorily met each R-AMSTAR criterion.
| Criterion | Description | Yes, % |
| Q 1.a | The design of the study was established before the conduct of the review (ie, a priori design). | 100 |
| Q 1.b | There was a statement of inclusion criteria. | 100 |
| Q 1.c | There was a PICO research question/statement. | 67 |
| Q 2.a | There were at least 2 independent data extractors as stated or implied. | 42 |
| Q 2.b | There was a statement of recognition or awareness of consensus procedure for disagreements. | 46 |
| Q 2.c | Disagreements among extractors were resolved properly as stated or implied. | 38 |
| Q 3.a | At least 2 electronic sources were searched (eg, Medline and EMBASE). | 96 |
| Q 3.b | The report includes years and databases searched. | 92 |
| Q 3.c | Key words and/or MESH terms are stated. | 92 |
| Q 3.d | In addition to the electronic databases (PubMed, EMBASE, Medline), the search was supplemented by consulting current contents such as reviews, textbooks, specialized registers, or experts in the particular field of study or by reviewing the references in the studies found. | 79 |
| Q 3.e | Journals were “hand searched” or “manual searched” (ie, identifying highly relevant journals and conducting a manual, page-by-page search of their entire contents looking for potentially eligible studies). | 13 |
| Q 4.a | The authors stated that they searched for reports regardless of publication type. | 8 |
| Q 4.b | The authors state whether or not they excluded any reports (from the systematic review), based on their publication status, language, etc. | 83 |
| Q 4.c | “NonEnglish” papers were translated. | 4 |
| Q 4.d | There was no language restriction or recognition of nonEnglish articles. | 21 |
| Q 5.a | Table/list/or figure of included studies was provided; a reference list does not suffice. | 92 |
| Q 5.b | Table/list/or figure of excluded studies was provided either in the article or in a supplemental source (ie, online). (Excluded studies refers to those studies seriously considered on the basis of title and/or abstract, but rejected after reading the body of the text.) | 25 |
| Q 5.c | Author satisfactorily/sufficiently stated the reason for exclusion of the seriously considered studies. | 63 |
| Q 5.d | Reader is able to retrace the included and the excluded studies anywhere in the article bibliography, reference, or supplemental source. | 25 |
| Q 6.a | The characteristics of the included studies are provided in an aggregated form such as a table, data from the original studies were provided on the participants, interventions AND outcomes. | 88 |
| Q 6.b | The authors provided the ranges of relevant characteristics in the studies analyzed (eg, age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases are reported). | 83 |
| Q 6.c | The information provided appears to be complete and accurate (ie, there is a tolerable range of subjectivity here. Is the reader left wondering? If so, state the needed information and the reasoning). | 88 |
| Q 7.a | A priori methods of assessment were provided (eg, for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. | 38 |
| Q 7.b | The scientific quality of the included studies appears to be meaningful (ie, a scale such as High, Low or A, B, C is used). | 33 |
| Q 7.c | Discussion/recognition/awareness of level of evidence | 21 |
| Q 7.d | Quality of evidence was rated/ranked based on characterized instruments (Characterized instrument is a created instrument that ranks the level of evidence, eg, GRADE). | 21 |
| Q 8.a | The results of the methodological rigor and scientific quality were considered in the analysis and the conclusions of the SR. | 25 |
| Q 8.b | The results of the methodological rigor and scientific quality were explicitly stated in formulating recommendations. | 25 |
| Q 8.c | To have conclusions integrated/drives towards a clinical consensus statement. | n/a |
| Q 8.d | This clinical consensus statement drives toward revision or confirmation of clinical practice guidelines. | n/a |
| Q 9.a | The authors provided a statement of criteria that were used to decide that the studies analyzed were similar enough to be pooled. | 0 |
| Q 9.b | For the pooled results, a test was performed to ensure the studies were combinable, to assess their homogeneity (ie, Chi-square test for homogeneity, I2). | 38 |
| Q 9.c | There was a recognition of heterogeneity or lack of thereof. | 38 |
| Q 9.d | If heterogeneity existed a “random effects model” was used and/or the rationale (ie, clinical appropriateness) of combining was taken into consideration (ie, was it sensible to combine), or stated explicitly. | 25 |
| Q 9.e | If homogeneity existed, the authors stated a rationale or a statistical test. | 0 |
| Q 10.a | Recognition of publication bias or file-drawer effect. | 21 |
| Q 10.b | Assessment of publication bias included graphical aids (eg, funnel plot, other available tests). | 13 |
| Q 10.c | Statistical tests (eg, Egger regression test). | 0 |
| Q 11.a | The authors provided a statement of sources of support. | 79 |
| Q 11.b | There was no conflict of interest. | 50 |
| Q 11.c | The authors provided an awareness/statement of support or conflict of interest in the primary inclusion studies. | 4 |