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| Appraisal | Description |
| ++ | All or most of the criteria are met. It is very unlikely that the criteria that were not met would change the conclusions of the study. |
| + | Some of the criteria are met. It is unlikely that the criteria that were not met would change the conclusions of the study. |
| – | Few or none of the criteria were met. It is likely or very likely that the criteria that were not met would change the conclusions of the study. |
