Systematic Review Process

Quality assessment applies SIGN, Drummond, and Cochrane Handbook tools in parallel to each included study. An article advances to full-text review only if at least two of three assigned screening authors agree on inclusion. One co-author and Elicit independently extract data, and a second co-author validates and compiles the results. All co-authors screen the same 10% of articles before full screening to calibrate agreement. Studies are classified as high, moderate, or low quality based on average scores across the three tools. Retrieved citations are imported into Rayyan for duplicate identification and removal. Data extraction uses a Microsoft Excel spreadsheet structured according to the CHEERS checklist. Title and abstract screening uses author pairs plus a third co-author for conflict resolution.