Records excluded (did not meet eligibility criteria)(n =511 )
Full-text articles assessed for eligibility(n =25 )
Studies included in quantitative synthesis (meta-analysis)(n = 14 )
Records screened based on review of title and abstracts (n =536 )
Records identified through database searching Pubmed/Embase/Cochrane library(n =817)
additional records identified through other sources(n =1)
Records after duplicates removed(n =282 )
Full-text articles excluded with reasons:1.Secondary analysis of previously published data2.Non-randomized controlled trial (non-RCT)3.Full text not retrievable (unavailable)(n=11)
