Risk of bias and quality of evidence assessment
Pairs of reviewers (Z.P.X., C.L.) independently appraised the risk of
bias (ROB) for RCTs using the Cochrane Risk of Bias tool (17). Six
domains, regarding selection, performance, attrition, detection,
reporting, and other sources of bias were assessed. The quality of
evidence for outcomes using
the
Grading of Recommendations Assessment, Development and Evaluation
(GRADE) framework (18). The GRADE approach results in an assessment of
the quality of a body of evidence as high, moderate, low, or very low,
according to five categories, including risk of bias, imprecision,
inconsistency, indirectness, and publication bias (19). Any
discrepancies were resolved through discussion, or by a third reviewer
(Z.S.D.).