The review addressed a clear question and was supported by reproducible eligibility criteria. Several electronic databases were searched. The restriction to studies in English meant that some relevant studies may have been missed. There did not appear to a strategy aimed specifically at identifying unpublished studies. Suitable methods were employed to reduce the risks of reviewer error and bias throughout the review.
The authors reported in their quality assessment results table that groups were similar at baseline in all studies yet they stated elsewhere in the report that two studies had baseline imbalances so the reliability of the study quality assessment results appeared questionable. Sufficient study details were provided.
A narrative synthesis appeared appropriate due to variations between studies (particularly in comparator treatments). Most studies had small group sizes so it was difficult to rule out the possibility of results arising by chance differences. There was no evaluation of the clinical relevance of results (statistical significance does not necessarily equate to clinical significance).
In light of these limitations the authors' conclusions may not be reliable.