Risk of bias analysis
| First author et al. and year | Random sequence generation (selection bias) | Allocation concealment (selection bias) | Blinding of participants and personnel (performance bias) | Blinding of outcome assessment (detection bias) | Incomplete outcome data (attrition bias) | Selective reporting (reporting bias) | Other bias |
|---|---|---|---|---|---|---|---|
| Ghaleb et al., 2024 | Low risk | Unclear | High risk | Low risk | Low risk | Low risk | Low risk |
| Bishara et al., 2008 | Low risk | Low risk | High risk | Low risk | Low risk | Low risk | Low risk |
| Shamsi et al., 2006 | Low risk | Unclear | High risk | Unclear | Low risk | Low risk | Low risk |
| Shammaa et al., 1999 (October) | Low risk | Low risk | Not applicable | Low risk | Low risk | Low risk | Low risk |
| Osorio et al., 1999 (February) | Low risk | Low risk | Not applicable | Low risk | Low risk | Low risk | Low risk |
Random sequence generation (selection bias): This assesses whether the allocation of treatments was randomized in a way that would not allow the predictor of allocation to be accounted for. Allocation concealment (selection bias) evaluates whether intervention allocations could have been foreseen before or during enrollment. Blinding of participants and personnel (performance bias): Considers if participants and those administering the interventions were blinded to group assignment. Blinding of outcome assessment (detection bias): Review whether the outcome assessors were blinded to the intervention provided. Incomplete outcome data (attrition bias): Looks at the completeness of outcome data for each primary outcome, including attrition and exclusions from the analysis. Selective reporting (reporting bias): Assesses if the reported findings include all of the study’s pre-specified outcomes. Other bias: Examines any potential source of bias not covered in the different domains