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. 2025 Aug 8;16:1618617. doi: 10.3389/fpsyg.2025.1618617

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Copyright © 2025 Zhang, Zhao, Ng, Liu, Liang, In Lao and Ning.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Bar graph illustrating the risk of bias across various factors in a study. Each factor, such as sequence generation and allocation concealment, is represented by a horizontal bar showing three sections: low risk (green), some concerns (yellow), and high risk (red). Sequence generation and selective reporting show the lowest risk, while allocation concealment and blinding have notable concerns. Overall, there are minimal high-risk indicators, but some concerns remain prevalent. A legend clarifies the colors’ meanings. — Risk of bias summary.