Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.

We are very pleased that this article [1] has received such good feedback from readers, and I also thank the author of this article and the letter to the editor for their significant advice, but I need to explain the situation.

Of course, it is very important to provide a systematic review and meta-analysis to search for all sources and increase the sensitivity of the article, but sometimes in one issue, increasing the number of databases does not indicate an increase in sensitivity, but it is important to use resources that include more articles. Therefore, the authors are focused on the resources available to all authors in the world, and in this case, Cochrane Library is not available to everyone, and most authors are not familiar with it.

The issue of publication bias is also a very important issue that should be considered in systematic review and metanalysis studies, in which case a general picture is provided to readers using a funnel plot that cannot be interpreted by eye. Therefore, it is expected that at the same time as presenting the funnel plot, the results of the statistical test will be reported to describe the publication bias. Because in the test the results are less than 0.05 meaningful and in this case 0.06 will not be significant. In this case, the most common test that is being studied by researchers is the Egger's test, and therefore, the authors have used this test to check the publication bias.