Table 2. Risk of Bias Assessment (RoB2) results.

🟢: low risk, 🟡: some concerns, 🔴: high risk

Study	Randomization	Deviations from intended interventions	Missing outcome data	Outcome measurement	Selection of reported results	Overall risk
Villanova-López et al. [11]	🟢 Low: Adequately described randomization and allocation	🟢 Low: Double-blinding maintained	🟢 Low: No significant missing data	🟢 Low: Outcome assessors were blinded	🟢 Low: No selective reporting	🟢 Low
Di Sante et al. [12]	🟡 Some concerns: Randomization method not fully described	🟡 Some concerns: Blinding details insufficient	🟢 Low: Minimal missing data	🟡 Some concerns: Unclear maintenance of blinding of outcome assessors	🟢 Low: No selective reporting	🟡 Some concerns
Dallari et al. [13]	🟢 Low: Well-described with allocation concealment	🟢 Low: Double-blinding maintained	🟢 Low: Minimal missing data	🟢 Low: Blinded assessors and consistent outcome measurement	🟢 Low: Pre-specified outcomes reported	🟢 Low
Nouri et al. [14]	🟡 Some concerns: Inadequate description of allocation concealment	🟡 Some concerns: Blinding unclear across multiple groups	🟢 Low: Minimal missing data	🟡 Some concerns: Unclear blinding of outcome assessors	🟢 Low: No selective reporting	🟡 Some concerns
Doria et al. [15]	🟡 Some concerns: Allocation concealment not described	🟡 Some concerns: Blinding insufficient for providers	🟢 Low: Minimal missing data	🟡 Some concerns: Unclear blinding of assessors	🟢 Low: No selective reporting	🟡 Some concerns