Fig. 9

Summary plot of ROBINS—I protocol for chosen studies. This summary plot presents the overall risk of bias for each study based on the ROBINS-I protocol. Each study is represented by a column, and the overall risk of bias for each study is color-coded according to the ROBINS-I scoring system (green for low risk, yellow for moderate risk, and red for high risk). This plot provides a comprehensive view of the methodological quality of the studies included in the systematic review, allowing for the assessment of how bias might have influenced the findings and conclusions drawn from the data