Each trial was analyzed for methodologic quality using a purpose-designed modified Jadad scale as first developed in Sarris and Byrne. Using the modified Jadad scale, studies were objectively assessed for quality and given 1 point when each of the following criteria was satisfied: (1) Was the study described as randomized? (2) Was the randomization protocol detailed and appropriate? (3) Was the study described
as double-blind? (4) Was the blinding process detailed and appropriate? (5) Did the study have a control group? (6) Was the control detailed and appropriate? (7) Were there adequate exclusion criteria? (8) Was the intervention used at a therapeutic dose? (9) Was there a description of withdrawals and dropouts? and (10) Were the data clearly and adequately reported? Using this scale, each trial was given a score between
0 and 10, with higher scores reflecting superior methodologic quality.