Systematic Review
From 1,771 initial records, 995 were screened after deduplication and 68 papers were ultimately included. There is no validated quality-assessment instrument for FRAM studies, so reporting completeness was used as a quality proxy. The revi…
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From 1,771 initial records, 995 were screened after deduplication and 68 papers were ultimately included. There is no validated quality-assessment instrument for FRAM studies, so reporting completeness was used as a quality proxy. The review follows PRISMA-P guidance and is registered in PROSPERO as CRD420251207651. The review could not produce a meta-analysis because included studies were heterogeneous. Data were extracted independently by two reviewers using a pre-defined extraction tool developed with a FRAM expert, with disagreements resolved by discussion or a third expert arbitrator. The systematic review searched seven databases up to December 2025, ultimately including 68 papers from 1,771 initial records. The protocol follows PRISMA-P guidelines and restricts eligible studies to randomised controlled trials only. Evidence certainty is graded using the GRADE framework across four certainty levels assessed through five domains including risk of bias, directness, heterogeneity, precision, and publication bias. Two independent reviewers will search seven biomedical databases from inception to 1 May 2025 with no restrictions on publication date, language, or population charact…