There was low- quality evidence that acupuncture  improves pain compared to no treatment or st and ard treatment , but good evidence that it is no better than sham acupuncture .
The evidence for homoeopathy , spinal manipulation and herbal medicine was limited .
No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM .
Background Fibromyalgia ( FM ) is a chronic , debilitating pain disorder .
Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine ( CAM ) .
Two previous overviews of systematic review s of CAM for FM have been published , but they did not assessed for risk of bias in the review process .
AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews.
OBJECTIVE Our purpose was to measure the agreement , reliability , construct validity , and feasibility of a measurement tool to assess  systematic review s ( AMSTAR ) . STUDY DESIGN AND SETTING We r and omly selected 30 systematic review s from a data base . Each was assessed by two review ers using : ( 1 ) the enhanced quality assessment question naire ( Overview of Quality Assessment Question naire [ OQAQ ] ) ; ( 2 ) Sacks ' instrument ; and ( 3 ) our newly developed measurement tool ( AMSTAR ) . We report on reliability ( interobserver kappas of the 11 AMSTAR items ) , intraclass correlation coefficients ( ICCs ) of the sum scores , construct validity ( ICCs of the sum scores of AMSTAR compared with those of other instruments ) , and completion times . RESULTS The interrater agreement of the individual items of AMSTAR was substantial with a mean kappa of 0.70 ( 95 % confidence interval [ CI ] : 0.57 , 0.83 ) ( range : 0.38 - 1.0 ) . Kappas recorded for the other instruments were 0.63 ( 95 % CI : 0.38 , 0.78 ) for enhanced OQAQ and 0.40 ( 95 % CI : 0.29 , 0.50 ) for the Sacks ' instrument . The ICC of the total score for AMSTAR was 0.84 ( 95 % CI : 0.65 , 0.92 ) compared with 0.91 ( 95 % CI : 0.82 , 0.96 ) for OQAQ and 0.86 ( 95 % CI : 0.71 , 0.94 ) for the Sacks ' instrument . AMSTAR proved easy to apply , each review taking about 15 minutes to complete . CONCLUSIONS AMSTAR has good agreement , reliability , construct validity , and feasibility . These findings need confirmation by a broader range of assessors and a more diverse range of review
There was low- quality evidence that acupuncture  improves pain compared to no treatment or st and ard treatment , but good evidence that it is no better than sham acupuncture .
The evidence for homoeopathy , spinal manipulation and herbal medicine was limited .
No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM .
Background Fibromyalgia ( FM ) is a chronic , debilitating pain disorder .
Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine ( CAM ) .
Two previous overviews of systematic review s of CAM for FM have been published , but they did not assessed for risk of bias in the review process .