Figures legends
Figure 1: PRISMA flow diagram for new systematic reviews which included searches of databases, registers, and other sources of the screening process.
Figure 2: Quality analysis of Systematic Reviews according to AMSTAR 2
Legend: D1. Did the research questions and inclusion criteria for the review include the components of PICO? YES or NO.”; D2. Did the report of the review contain an explicit statement that the review methods were established prior to the conduct of the review and did the report justify any significant deviations from the protocol? YES, PARTIAL YES or NO.; D3. Did the review authors explain their selection of the study designs for inclusion in the review? YES or NO.; D4. Did the review authors use a comprehensive literature search strategy? YES, PARTIAL YES or NO.; D5. Did the review authors perform study selection in duplicate? YES or NO.; D6. Did the review authors perform data extraction in duplicate? YES or NO.; D7. Did the review authors provide a list of excluded studies and justify the exclusions? YES, PARTIAL YES or NO.; D8. Did the review authors describe the included studies in adequate detail? YES, PARTIAL YES or NO.; D9. Did the review authors use a satisfactory technique for assessing the risk of bias (RoB) in individual studies that were included in the review? YES, PARTIAL YES or NO.; D10. Did the review authors report on the sources of funding for the studies included in the review? YES or NO.; D11. If meta-analysis was performed did the review authors use appropriate methods for statistical combination of results? Yes, No or No meta-analysis conducted.; D12. If meta-analysis was performed, did the review authors assess the potential impact of RoB in individual studies on the results of the meta-analysis or other evidence synthesis? Yes, No or No meta-analysis conducted.; D13. Did the review authors account for RoB in individual studies when interpreting/ discussing the results of the review? Yes, No or No meta-analysis conducted.; D14. Did the review authors provide a satisfactory explanation for, and discussion of, any heterogeneity observed in the results of the review? YES or NO.; D15. If they performed quantitative synthesis did the review authors carry out an adequate investigation of publication bias (small study bias) and discuss its likely impact on the results of the review? Yes, No or No meta-analysis conducted.; D16. Did the review authors report any potential sources of conflict of interest, including any funding they received for conducting the review? YES or NO. Y= Yes, N= No, N/MA= No meta-analysis conducted.
Figure 3: Rating overall confidence in the results of the review according to AMSTAR2.
Figure 4: Quality analysis of Systematic Reviews according to OQAQ.
Legend: D1. Were the search methods reported? D2. Was the search comprehensive? D3. Were the inclusion criteria reported? D4. Was selection bias avoided? D5. Were the validity criteria reported? D6. Was validity assessed appropriately? D7. Were the methods used to combine studies reported? D8. Were the findings combined appropriately? D9. Were the conclusions supported by the reported data? D10. What was the overall scientific quality of the overview? Y= YES, N= NO, CT= Can’t Tell.
Figure 5: Quality analysis of Systematic Reviews according to CASP.
Legend: D1. Did the review address a clearly focused question? D2. Did the authors look for the right type of papers? D3. “Do you think all the important, relevant studies were included? D4. Did the review’s authors do enough to assess quality of the included studies? D5. If the results of the review have been combined, was it reasonable to do so? D6. What are the overall results of the review? D7. How precise are the results? D8. Can the results be applied to the local population? D9. Were all important outcomes considered? D10. Are the benefits worth the harms and costs? Y= YES, N= NO, CT= Can’t Tell.
Figure 6. Identifying concerns with the review process according to ROBIS 2 tool domains. Domain 1: study eligibility criteria; Domain 2: identification and selection of studies; Domain 3: data collection and study appraisal; Domain 4: synthesis and findings.
Legend: D1.1 Did the review adhere to pre-defined objectives and eligibility criteria? Y/PY/PN/N/NI.; D1.2 Were the eligibility criteria appropriate for the review question? Y/PY/PN/N/NI.; D1.3 Were eligibility criteria unambiguous? Y/PY/PN/N/NI; D1.4 Were any restrictions in eligibility criteria based on study characteristics appropriate (e.g. date, sample size, study quality, outcomes measured)? Y/PY/PN/N/NI; D1.5 Were any restrictions in eligibility criteria based on sources of information appropriate (e.g. publication status or format, language, availability of data)? Y/PY/PN/N/NI; D2.1 Did the search include an appropriate range of databases/electronic sources for published and unpublished reports? Y/PY/PN/N/NI; D2.2 Were methods additional to database searching used to identify relevant reports? Y/PY/PN/N/NI; D2.3 Were the terms and structure of the search strategy likely to retrieve as many eligible studies as possible? Y/PY/PN/N/NI; D2.4 Were restrictions based on date, publication format, or language appropriate? Y/PY/PN/N/NI; D2.5 Were efforts made to minimise error in selection of studies? Y/PY/PN/N/NI; D3.1 Were efforts made to minimise error in data collection? Y/PY/PN/N/NI; D3.2 Were sufficient study characteristics available for both review authors and readers to be able to interpret the results? Y/PY/PN/N/NI; D3.3 Were all relevant study results collected for use in the synthesis? Y/PY/PN/N/NI D3.4 Was risk of bias (or methodological quality) formally assessed using appropriate criteria? Y/PY/PN/N/NI; D3.5 Were efforts made to minimise error in risk of bias assessment? Y/PY/PN/N/NI; D4.1 Did the synthesis include all studies that it should? Y/PY/PN/N/NI 4.2 Were all pre-defined analyses reported or departures explained? Y/PY/PN/N/NI; D4.3 Was the synthesis appropriate given the nature and similarity in the research questions, study designs and outcomes across included studies? Y/PY/PN/N/NI; D4.4 Was between-study variation (heterogeneity) minimal or addressed in the synthesis? Y/PY/PN/N/NI; D4.5 Were the findings robust, e.g. as demonstrated through funnel plot or sensitivity analyses? Y/PY/PN/N/NI; D4.6 Were biases in primary studies minimal or addressed in the synthesis? Y=YES, PY=PROBABLY YES, PN=PROBABLY NO, N=NO, NI=NO INFORMATION
Figure 7: Bias risk classification according to ROBIS 2 domains.