Abstract
This response letter addresses the comments received on our paper. The main points of our response include: Clarification of the definitions of primary and secondary indexes; Justification for the use of the RoB2 tool for quality assessment; Measures to improve sensitivity analysis and data consistency; Explanation and improvement plans regarding the timing of Prospero registration. We have provided detailed explanations of the study design and outlined specific measures for future improvements to enhance research transparency and quality.