OBJECTIVES : Systematic reviews (SRs) summarize the outcomes of various trials and studies and are widely used for obtaining the “bottom line” in order to keep up with the literature, clinical guidelines and other decisions in healthcare. Assessment of quality of these SRs is very important as substandard SRs can be misleading and harmful. AMSTAR tool is widely used for the quality assessment of SRs, while the ROBIS tool was recently launched to specifically assess risk of bias of SRs.

METHODS : The main objective of this review is to compare rigorously the AMSTAR and ROBIS tools in determining the methodological quality of the included systematic reviews published in Alzheimer's Disease (AD). PubMed was searched from inception till July 2017. Reference lists of the included studies were also hand-searched. All reviews including patients with AD, where the intervention was compared to placebo, treatment as usual or waitlist controls with cognitive function and behavioral outcomes were included.

RESULTS : We identified 37 reviews that met our inclusion criteria. Using AMSTAR tool 23 reviews (62.16%) scored between 9 and 10, indicating a high quality, while 7 reviews (18.92%) scored 6. However, using ROBIS tool - 25 reviews (67.57%) showed high risk of bias, suggesting a low quality, while 8 reviews (21.62%) and 4 reviews (10.81%) showed unclear and low risk of bias, respectively.

CONCLUSIONS : The review suggests that ROBIS as a more rigorous tool in assessing the methodological quality of the included systematic reviews compared to AMSTAR. Hence, ROBIS can be used specifically to assess the risk of bias in systematic reviews. More validation studies are needed to investigate reliability and applicability, in particular.