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All Exp Med Surg Exp Proc Surg Exp Surg Studies (N) 14 27 2 1 18 9 1 25 ninety seven a Location North America eight 9 0 1 7 zero zero zero 25 Europe 5 eleven 2 zero 4 7 1 15 45 Asia zero three zero 0 7 2 zero eight 20 Middle East 1 4 0 zero 0 zero zero 1 6 South America zero zero zero 0 0 zero 0 1 1 Decade of 1985 to1995 2 6 1 zero 0 zero 0 0 9 Publication 1996 to 2005 5 eight 1 zero three 2 zero 10 29 2006 to 2016 7 thirteen zero 1 15 7 1 15 fifty nine Study Quality Good 2 2 0 zero 4 2 zero 8 18 Fair 5 7 0 1 four 3 0 7 27 Poor 7 18 2 zero 10 4 1 10 52 Participants Randomized 1,159 2,570 114 20 1,171 962 181 3,002 9,179 Note: None of the included studies compared treatment with process or process with expectant management Exp = expectant administration; Med = medical; N = quantity; Proc = procedural; Surg = surgical aIncludes studies conducted within the United States, Canada, and Cuba. 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