Risk of bias analysis

First author et al. and yearRandom 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., 2024Low riskUnclearHigh riskLow riskLow riskLow riskLow risk
Bishara et al., 2008Low riskLow riskHigh riskLow riskLow riskLow riskLow risk
Shamsi et al., 2006Low riskUnclearHigh riskUnclearLow riskLow riskLow risk
Shammaa et al., 1999 (October)Low riskLow riskNot applicableLow riskLow riskLow riskLow risk
Osorio et al., 1999 (February)Low riskLow riskNot applicableLow riskLow riskLow riskLow 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