Two authors (SZ and LL) evaluated the quality and risk of bias of the included SR/meta-analysis independently using the Risk of Bias in Systematic reviews tool and PRISMA.[38] A consensus is reached by 2 reviewers through discussion, and independent decisions are made by experts (JX) if necessary.

The tool assessment of multiple systematic reviews-2 (AMSTAR-2)[39] will be referenced to assess the methodological quality of the SRs and meta-analyses by 2 separate reviewers (ZZ and GT). If disagreements occur, it would be solved through discussion between 2 reviewers or consulting the expert's (JX) decision.

The quality of evidence will be evaluated using the GRADE approach.[40] The evidence quality of all outcomes will be rated on 4 levels (high, medium, low, or very low). Two reviewers (XZ and HG) will conduct the assessment process separately and describe in detail the reasons for downgraded or upgraded outcomes affecting the quality of evidence to guarantee the reliability and transparency of results.

If the specific information is not reported, we will attempt to contact the original author for relevant information. If the required information is not available, it will be explained in the article. Then, the analysis will rely on existing data, and discuss the potential impact of missing information.

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