Table 1.

Relevance and Risk of Bias for the Considered Studies

	Relevance					Risk of Bias
First Author (Year)	Design	Patients (a)	Exposure (b)	Cochleovestibular Toxicity (c)	Outcome (d)	Accuracy of Experimental Design (e)	Selective Reporting (f)	Sample Size (g)
Organ transplantation
Hartnick (2000)11	RCS	●	●	●	●	●	○	○
Fortes (2008)13	PCS	●	●	●	○	●	●	○
Rifai (2012)12	RCS	●	○	●	○	○	○	○
Gulleroglu (2015)14	PCS	●	●	●	●	●	●	○
Arinsoy (1993)21	CR	●	●	●	●	N/A	N/A	N/A
Hartnick (1997)20	CR	●	●	●	●	○	N/A	N/A
Min (1999)16	CR	●	●	●	●	○	N/A	N/A
Marioni (2004)10	CR	●	●	●	●	●	N/A	N/A
Norman (2006)18	CR	●	●	●	●	○	N/A	N/A
Rifai (2006)25	CR	●	●	●	●	○	N/A	N/A
Gulleroglu (2013)26	CR	●	●	●	●	○	N/A	N/A
Jenkinson (2014)22	CR	○	●	●	●	○	N/A	N/A
Lakshmi(2020)24	CR	●	●	●	○	○	N/A	N/A
Autoimmune disease
Savastano (2010)8	RCS	●	●	●	○	○	●	○
Ahmadzadhe (2017)15	CCS	●	○	●	○	○	●	○
Porges (1998)19	CR	○	●	●	○	○	N/A	N/A
Swale (2005)17	CR	○	●	●	●	N/A	N/A	N/A
Tuknayat (2017)23	CR	○	●	●	●	○	N/A	N/A

CCS, case–control study; CR, case report; N/A, not applicable; PCS, prospective cohort study; RCS, retrospective cohort study.

Patients (a): requiring immunosuppressive therapy ● after transplantation; ○ for autoimmune diseases;

Exposure (b): ● reported immunosuppressant drugs with the detailed protocol used or serum level at symptom onset; ○ missing information;

Cochleovestibular toxicity (c): ● tinnitus, vertigo, or HL (confirmed by audiometry) attributed to immunosuppressant regimen; ○ ototoxicity not reported;

Outcome (d): ● hearing recovery/stabilization confirmed by audiometry after therapy discontinuation or dose correction; ○ hearing worsening or outcome not specified;

Selective reporting (e): ● well-defined and adequately described inclusion and exclusion criteria; ○ inadequate;

Accuracy of experimental design (f): ● as ASHA Guidelines for the Audiologic Management of Individuals Receiving Cochleotoxic Drug; ○ inadequate;

Sample size (g): ● sample size adequacy to detect rare adverse events according to Wu Yu-Te et al⁵³; ○ inadequate.