AMSTAR proved to be feasible to apply in quality assessment of TCM systematic reviews; the main problems emerged were the absence of guidance for certain item response, such as item 5 "was a list of studies (included and excluded) provided," to get "yes" score, four situations may be encountered: list of included studies provided, list of excluded studies provided, both lists of included and excluded studies provided in the same time, and the characteristics of the included studies presented; it is difficult to reach a final conclusion without more detailed directions regarding its use. Those items (4 and 7) with relatively low kappa values identified by Shea et al. [8] , on the contrast, presented more precisely guidance, were easy to apply and easily reached consensus among raters.