The Newcastle-Ottawa scale (NOS), which has been widely used in meta-analyses 17, 18, was applied to evaluate the risk of bias in the included studies 19. NOS contains three main categories, namely, selection, scored with four stars; comparability, scored with two stars; and ascertainment of the outcome, scored with three stars. Any study with a score of 1 in the selection or outcome ascertainment, 0 in any of the three domains, or a total score of less than 5 was deemed to have a high risk of bias 17, 18.

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