Table 6.

Certainty of evidence for improvement of FIQ/FIQR scores after treatment.

Quality Assessment						Summary of Findings, SMD (95% CI)
Number of Participants (Studies), Follow-Up Period	Risk of Bias	Inconsistency	Indirectness	Imprecision	Publication Bias	Sham	rTMS	Certainty of Evidence
228 (9), immediately post-intervention	No serious limitation a	Serious limitation b	No serious limitation c	Serious limitation d	Undetectable	−0.383 (−0.597, −0.170) e	−1.165 (−1.492, −0.837) f	Low ⨁⨁◯◯
139 (6), 2 weeks to 1 month after the last session	No serious limitation a	No serious limitation b	No serious limitation c	Serious limitation d	Undetectable	−0.387 (−0.719, −0.055) g	−1.157 (−1.579, −0.735) h	Moderate ⨁⨁⨁◯

CI: confidence interval; FIQ: Fibromyalgia Impact Questionnaire; FIQR: Revised Fibromyalgia Impact Questionnaire; rTMS: repetitive transcranial magnetic stimulation; SMD: standardized mean difference. ^a Most studies included scored low risk of bias during assessment. ^b The I² was over 50% during the first follow-up and below 50% at the second follow-up. ^c No indirectness was detected in this outcome. ^d The upper and lower limit of 95% CI ranged from large to small effect size. ^e This was calculated by pooling the sham group of the 11 comparisons included in the primary outcome, comparing the FIQ/FIQR score before and after treatment. ^f This was calculated by pooling the rTMS group of the 11 comparisons included in the primary outcome, comparing the FIQ/FIQR score before and after treatment. ^g This was calculated by pooling the rTMS group of the 5 studies included in the primary outcome and provided baseline data, comparing the FIQ/FIQR score before and 2 weeks to 1 month after treatment. ^h This was calculated by pooling the rTMS group of the 5 studies included in the primary outcome and provided baseline data, comparing the FIQ/FIQR score before and 2 weeks to 1 month after treatment.