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Article History

Received: 7 April 2026

Accepted: 4 June 2026

First Online: 19 June 2026

Declarations

Competing interests: The authors declare no competing interests.

Ethical approval and consent to participate: This study was conducted as a systematic review and meta-analysis of previously published randomized controlled trials. As the study did not involve the collection of primary data from human participants and relied exclusively on publicly available data from published studies, ethical approval and informed consent were not required in accordance with institutional and international research ethics guidelines.

Consent for publication: All authors have read and approved the final version of the manuscript and consent to its publication.

Use of artificial intelligence: The authors used a large language model (Anthropic Claude) as a writing-assistance tool to support copy-editing, language polishing, and the organization of methodological and discussion paragraphs of this manuscript. All study design, search strategy, eligibility decisions, data extraction, statistical analyses, risk-of-bias judgements, GRADE certainty assessments, and clinical interpretation were conceived, performed, and verified by the human authors. The authors reviewed and edited all AI-assisted text and take full responsibility for the content, accuracy, and integrity of the manuscript.