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  1. M A Silva1,
  2. B Hegab1,
  3. C Hyde2,
  4. B Guo2,
  5. J A C Buckels1,
  6. D F Mirza1
  1. 1
    University Hospital Birmingham Foundation Trust, Birmingham, UK
  2. 2
    University of Birmingham, UK
  1. Mr D F Mirza, University Hospital Birmingham Foundation Trust, Birmingham B15 2TH, UK; darius.mirza{at}uhb.nhs.uk

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We thank Germani et al for their comments in response to our paper. In the absence of randomised controlled studies, we based our review on the guidelines set out by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) group, as a systematic review and meta-analysis of observational studies.1 On the basis of these guidelines using robust search strategies, only eight studies fulfilled inclusion …

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