Table II.

Assessment of methodological quality with AMSTAR 2 tool for each comparison of the efficacy and safety outcomes

Author, year reference	AMSTAR-2 DOMAIN																Overall confidence in the results*
	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16
Leo, 2015 28																	Critically low
Lynch, 2015 29																	Critically low
Sclafani, 2015 30																	Critically low
Frautschi, 2017 31																	Low
Lei, 2019 32																	Low
Gupta, 2019 33																	Low
Kaushik, 2019 34																	Critically low
Maisel-Campbell, 2020 35																	Low
Nanda, 2021 36																	Critically low
Xiao, 2021 37																	Low
Evans, 2021 38																	High
Buzalaf, 2022 39																	Critically low
Gentile, 2023 40																	Low

Methodological requirement met

Methodological requirement partly met, or not specified

Methodological requirement unmet

Amstar-2 domains. Although AMSTAR 2 consists of 16 items, critical domains include items 2, 4, 7, 9, 11, 13, and 15

Did the research questions and inclusion criteria for the review include the components of PICO? Did the report of the review contain an explicit statement that the review methods were established prior to the conduct of the review and did the report justify any significant deviations from the protocol? Did the review authors explain their selection of the study designs for inclusion in the review? Did the review authors use a comprehensive literature search strategy? Did the review authors perform study selection in duplicate? Did the review authors perform data extraction in duplicate? Did the review authors provide a list of excluded studies and justify the exclusions? Did the review authors describe the included studies in adequate detail? Did the review authors use a satisfactory technique for assessing the risk of bias (RoB) in individual studies that were included in the review? Did the review authors report on the sources of funding for the studies included in the review? If meta-analysis was performed did the review authors use appropriate methods for statistical combination of results? If meta-analysis was performed, did the review authors assess the potential impact of RoB in individual studies on the results of the meta-analysis or other evidence synthesis? Did the review authors account for RoB in individual studies when interpreting/ discussing the results of the review? Did the review authors provide a satisfactory explanation for, and discussion of, any heterogeneity? If they performed quantitative synthesis did the review authors carry out an adequate investigation of publication bias (small study bias) and discuss its likely impact on the results of the review? Did the review authors report any potential sources of conflict of interest, including any funding they received for conducting the review?

*We rated overall confidence in the results of the review according to Shea et al.24, as follows: high, no or one non-critical weakness; moderate, more than one non-critical weakness but no critical flaws. Multiple non-critical weaknesses may diminish confidence in the review and it may be appropriate to move the overall appraisal down from moderate to low confidence; low, one critical flaw with or without non-critical weaknesses; critically low, more than one critical flaw with or without non-critical weaknesses.