Table 3.

Risk of Bias Assessed by the Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials Tools^a

Authors	Q.1	Q.2	Q.3	Q.4	Q.5	Q.6	Q.7	Q.8	Q.9	Q.10	Q.11	Q.12	Q.13	% Yes/Risk
Jejurikar et al. 201420	U	U	√	–	NA	–	√	√	√	√	√	√	√	66.6% moderate
Eppright et al. 20144	√	√	√	–	NA	√	√	√	√	√	√	√	√	91.6% low
Bowen et al. 20155	√	√	√	√	NA	–	√	√	√	√	√	√	√	91.6% low
Li et al. 20167	√	√	√	–	NA	–	√	√	√	√	√	√	√	83.3% low
Zotti et al. 20161	√	√	√	–	NA	√	√	√	√	√	√	√	√	75% low
Cozzani et al. 20166	√	√	√	√	NA	√	√	√	√	√	√	√	√	83.3% low
Alkadhi et al. 201721	√	√	√	–	NA	√	√	√	√	√	√	√	√	91.6% low

^aThe risk of bias was ranked as high when the study reached up to 49% of “yes” scores, moderate when the study reached from 50% to 69% of “yes” scores, and low when the study reached more than70% of “yes” scores. U indicates unclear; √, yes; –, no; NA, not applicable. Q.1: Was true randomization used for assigning participants to treatment groups? Q.2: Was allocation to treatment groups concealed? Q.3: Were treatment groups similar at baseline? Q.4: Were participants blind to the treatment assignment? Q.5: Were those delivering the treatment blind to the treatment assignment? Q.6: Were the outcome assessors blind to the treatment assignment? Q.7: Were the treatment groups treated identically other than the intervention of interest? Q.8: Was follow-up completed and, if not, were the differences between groups in terms of their follow up adequately described and analyzed? Q.9: Were the participants analyzed in the groups in which they were randomized? Q.10: Were the outcomes measured in the same way for the treatment groups? Q.11: Were the outcomes measured in a reliable way? Q.12: Was appropriate statistical analysis used? Q.13: Was the trial design appropriate and were any deviations from the standard randomized control trial design (individual randomization, parallel groups) accounted for in the conduct and analysis of the trial?