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3.3. Risk of bias in studies  Table 12 displays the methodical assessment of bias risk for every included study using the Newcastle-Ottawa Scale (NOS). Based on the number of stars given in each of the three primary domains—Selection, Comparability, and Outcome/Exposure—the quality rating table groups research. Research with seven to nine stars were classified as high quality, whereas studies with four to six stars were classified as moderate quality. In our review, no study received a low-quality rating (0-3 stars). The comprehensive evaluation of every study is shown in Table 12, where the majority of the studies receive high-quality ratings. For example, Study 5 was rated as intermediate quality with 6 stars, whereas Study 1 obtained 8 stars, indicating a high degree of quality in all domains. The chart provides openness on potential biases by clearly outlining the domains where research was strong or poor. By ensuring that only papers with sound techniques were included in our evaluation, this risk of bias assessment increased confidence in the study's overall conclusions. Additional steps were taken to confirm the study's validity through external cross-referencing in cases where proprietary  tools or insufficient data generated uncertainties, ensuring that our judgments remained impartial and correct.

Table 12 3.3. Risk of bias in studies Table 12 displays the methodical assessment of bias risk for every included study using the Newcastle-Ottawa Scale (NOS). Based on the number of stars given in each of the three primary domains—Selection, Comparability, and Outcome/Exposure—the quality rating table groups research. Research with seven to nine stars were classified as high quality, whereas studies with four to six stars were classified as moderate quality. In our review, no study received a low-quality rating (0-3 stars). The comprehensive evaluation of every study is shown in Table 12, where the majority of the studies receive high-quality ratings. For example, Study 5 was rated as intermediate quality with 6 stars, whereas Study 1 obtained 8 stars, indicating a high degree of quality in all domains. The chart provides openness on potential biases by clearly outlining the domains where research was strong or poor. By ensuring that only papers with sound techniques were included in our evaluation, this risk of bias assessment increased confidence in the study's overall conclusions. Additional steps were taken to confirm the study's validity through external cross-referencing in cases where proprietary tools or insufficient data generated uncertainties, ensuring that our judgments remained impartial and correct.