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However, though AMSTAR-2 was considered most fitted amongst current high quality appraisal tools for our review [12], it has been previously discovered to set very excessive requirements for its quality classifications [14,45,46,47]. A totally different high quality appraisal software may have yielded totally different outcomes. The insufficient reporting of the effect sizes across the included systematic evaluations precluded us from summarizing the evidence in quantitative terms. Further, our umbrella evaluation included systematic reviews without imposing a restriction on publication date. Our study highlights essential methodological weaknesses of the prevailing systematic reviews.