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Comparison of AMSTAR 2 and ROBIS Ratings and Inter-Rater Reliability for Each Scale Based on Systematic

Monika Storman1, Dawid Storman2, Mateusz J Świerz2

  • 1Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.

Obesity Reviews : an Official Journal of the International Association for the Study of Obesity
|May 5, 2026
PubMed
Summary

Systematic reviews and meta-analyses in bariatric research from 2016-2017 were critically low in quality. Both AMSTAR 2 and ROBIS tools showed moderate reliability, but calibration is recommended.

Keywords:
AMSTAR 2ROBISmeta‐analysisobesityrisk of biassystematic review

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Area of Science:

  • Bariatric Surgery Research
  • Systematic Reviews and Meta-Analyses
  • Research Quality Assessment

Background:

  • Systematic reviews and meta-analyses (SRs/MAs) are crucial for evidence-based medicine, particularly in bariatric surgery.
  • Assessing the methodological quality and risk of bias of SRs/MAs is essential for reliable clinical decision-making.
  • The AMSTAR 2 and ROBIS tools are commonly used for evaluating SRs/MAs.

Purpose of the Study:

  • To compare the quality and risk of bias ratings of bariatric research SRs/MAs published in 2016-2017.
  • To evaluate the performance of the AMSTAR 2 and ROBIS assessment tools in this specific research domain.

Main Methods:

  • A systematic survey identified SRs/MAs on bariatric surgery outcomes from 2016-2017.
  • Two independent reviewers assessed SRs/MAs using AMSTAR 2 and ROBIS, with discrepancies resolved by a third reviewer.
  • Inter-rater reliability and agreement between instruments were statistically analyzed.

Main Results:

  • Out of 78 included SRs/MAs, 98.7% were rated as critically low quality by AMSTAR 2.
  • ROBIS classified 6.4% as low risk of bias, 78.2% as high, and 15.4% as unclear.
  • Both tools demonstrated moderate inter-rater reliability for individual items and overall judgments.

Conclusions:

  • The methodological quality of SRs/MAs in bariatric research is predominantly critically low.
  • Calibration exercises are strongly recommended before applying AMSTAR 2 or ROBIS.
  • The choice between AMSTAR 2 and ROBIS should align with the specific research objective, as they address distinct questions.