Assessing the Certainty of the Evidence

We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach 21 to evaluate the certainty of the body of evidence for the comparison between T. terrestris versus placebo for the primary outcomes. We assessed the certainty of the evidence in all five GRADE domains (risk of bias, inconsistency, imprecision, indirectness, and publication bias). We report reasons to downgrade or upgrade the evidence. We present a summary of findings table using the software GRADEpro GDT (McMaster University, Hamilton, ON, Canada).22