We synthesized the evidence from acceptable or high-quality RCTs according to the SWiM Guideline and reported them in evidence tables [48]. We used two criteria to determine whether SMT was efficacious or effective. First, a study had to provide evidence that the null hypothesis was an unlikely hypothesis (p < 0.05) for the observed between-group difference in the primary outcome [62]. Second, if a difference was found, we determined whether the difference was clinically important. When available, we used standardized measurements (minimal clinically important difference [MCID]) to determine whether clinically important differences were reached in each trial. If the clinical importance of a statistically significant difference was not reported in the article, we planned to discuss the findings among Global Summit participants and reach consensus on its clinical importance. We used 75% agreement (38/50 participants) as the threshold for consensus.

We restricted our synthesis to RCTs with acceptable/high methodological quality because low/unacceptable quality trials are more likely to yield biased estimates of effect sizes [5761]. To understand the impact of methodological quality on trial results, we contrasted results from methodologically acceptable studies with those from the unacceptable studies. The SWiM guideline was published after the registration of our protocol on PROSPERO [48]. Nevertheless, we adopted it to ensure that our evidence synthesis complied with the most current methods of reporting. We had initially planned to stratify the synthesis by primary prevention, secondary prevention and tertiary prevention. However, we revised this plan and synthesized the evidence by non-musculoskeletal disorder because there were no studies, and very few studies, to inform primary and tertiary prevention, respectively. We further synthesized the evidence, based on the study design (efficacy versus effectiveness).

We tabulated disease-specific outcomes as reported in the individual papers by comparing the outcomes for SMT to the outcomes for control interventions. These comparisons informed the development of an evidence statement for each non-musculoskeletal disorder. Because the studies were clinically heterogeneous, we did not assess for statistical heterogeneity of effects across studies.

We present our main results in a series of tables. First, we report our consensus methodological quality assessment in the risk of bias table. Second, the study characteristics and key study results are presented in the evidence table. Finally, we provide a succinct evidence table, which summarizes the key characteristics and results of all studies to facilitate the comparison of study results according to study quality. We examined the direction and magnitude of effect sizes across RCTs according to methodological quality by comparing studies rated as high/acceptable quality versus those rated as low/unacceptable quality.

We developed a consensus-based, narrative evidence statement for each non-musculoskeletal disorder. However, since the rationale for treatment is the same across conditions, these statements synthesize the evidence about the efficacy and effectiveness of SMT for the prevention and management of the specific non-musculoskeletal disorder in general, in accordance with our research questions.

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