Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis

Figures

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  Figure 1. PRISMA 2020 flow diagram for the systematic review stages: the PRISMA flow diagram details the systematic review methodology, illustrating the phases of study identification, screening, and inclusion. CENTRAL, Cochrane Central Register of Controlled Trials; ICTRP, International Clinical Trials Registry Platform; IIEF, International Index of Erectile Function; ISRCTN, International Standard Randomized Controlled Trial Number; OATD, Open Access Theses and Dissertations; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-analyses.

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  Figure 2. Weighted mean difference (WMD)–based forest plot assessing cardiac rehabilitation effects on erectile dysfunction in studies employing the IIEF-5: this forest plot summarizes the cardiac rehabilitation effect on erectile dysfunction, quantified by WMD in the studies that utilized the IIEF-5. The WMD and 95% CIs were calculated via a random effects meta-analysis. Heterogeneity among studies was assessed with the I2 statistic and Cochran’s Q test. ES, effect size; IIEF-5, 5-item International Index of Erectile Function.

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  Figure 3. Traffic light and summary plot of risk of bias (RoB): this figure presents a comprehensive visual representation of the RoB assessment conducted per the Cochrane Collaboration tool. This summary plot employs a traffic light color-coding system to depict the level of RoB in various studies. Indicators represent studies deemed to be free of RoB within a specific domain, those with RoB, and instances where the RoB remains unclear or undetermined.

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  Figure 4. dppc2 forest plot stratified by selective outcome reporting in risk of bias: this forest plot displays the stratification of studies by the selective outcome reporting domain of the risk-of-bias assessment, utilizing the dppc2 metric. The dppc2 and 95% CIs were calculated via a random effects meta-analysis. Heterogeneity among studies was assessed with the I2 statistic and Cochran’s Q test. ES, effect size.

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  Figure 5. Sensitivity analysis of studies in the meta-analysis: this sensitivity analysis plot illustrates the stability of the combined effect size for the included studies when individual studies are excluded. The plot highlights the consistency of effect sizes within the 95% CI of the overall analysis, except for the notable deviation seen with the exclusion of Pournaghash-Tehrani et al.20 The effect size estimate (dppc2) and 95% CIs were calculated via a random effects meta-analysis.