The Cochrane tool for assessing the risk of bias was used to assess whether there was high, low, or unclear risk of bias in the following domains: random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective outcome reporting, and other sources of bias.17 KHT (all papers) and DG and RMM (papers equally shared) assessed the risk of bias. Discrepancies were resolved by referring to the original publications and discussion among all three reviewers. KHT also contacted study authors to obtain study protocols and additional information that might not have been published to aid with assessment of the risk of bias.