Supplementary Table 4. Quality assessment of each study using Modified Newcastle Ottawa Scale. Study Selection Bias Exposure Bias Comparability Bias Outcome Bias Definition of population Source population Typical of average population Sample size How performance using hop test(s) was decided Demonstrates outcome was not present at time of hop testing Comparability of cohort on the bias of the design or analysis Validity and reliability of outcomes Assessment of outcome(s) of interest Adequacy of follow up Bodkin et al., 2022 Low Low Low High High Low Low High High Low Cristiani et al., 2022 Low Low Low High Low Low Low Low Low Low Cristiani et al., 2025 Low Low Low High Low Low Low Low Low Low Faleide et al., 2021 Low Low Low High Low Low Low High High High Figueroa et al., 2025 Low Low Low Low High Low High Low Low Low Fältström et al., 2023 Low Low High High Low Low High Low Low Low Girdwood et al., 2024 Low Low Low High Low Low Low High High High Grindem et al., 2016 Low Low Low High Low Low Low Low Low Low Ithurburn et al., 2019 Low Low Low High Low Low High Low Low High Jang et al., 2014 Low Low High High High Low High High High High Kew et al., 2022 Low Low Low High High Low High High High Low Kim et al., 2022 Low Low Low High High Low High Low Low Low King et al., 2021 Low Low Low High Low Low Low Low Low Low Kitaguchi et al., 2020 Low Low Low Low High Low Low High High High Kyritsis et al., 2016 Low Low Low High Low Low High Low Low Low Legnani et al., 2024 Low Low Low Low Low Low High Low Low Low Marigi et al., 2023 Low Low Low High Low Low High Low Low High Marty-Diloy et al., 2025 Low Low Low High Low Low High High High Low Moksnes et al., 2009 Low Low High High Low Low High Low Low High Müller et al., 2015 Low Low Low High Low Low Low Low Low Low Nawasreh et al., 2018 Low Low Low High High Low Low Low Low High Niederer et al., 2024 Low Low Low High Low Low Low Low Low Low Niederer et al., 2025 Low Low Low High High Low High Low Low Low Novaretti et al., 2018 Low Low Low Low High Low Low Low Low High Nyland et al., 2025 Low Low Low High Low Low High High High Low Ohji et al., 2024 Low Low Low High Low High Low Low Low Low Ohji et al., 2021a Low Low Low High Low High Low Low Low Low Ohji et al., 2021b Low Low Low High Low High High Low Low Low Paterno et al., 2022 Low Low Low High High Low Low Low Low Low Paterno et al., 2025 Low Low Low High Low Low Low Low Low Low Piussi et al., 2023 Low Low Low High Low Low Low High High High Senorski et al., 2017 Low Low Low High Low Low High Low Low High Simonsson et al., 2024 Low Low Low High Low Low High Low Low Low Toole et al., 2017 Low Low Low High Low Low High Low Low Low Ueda et al., 2022 Low Low Low High High High Low High High High van Melick et al., 2022 Low Low Low High Low Low High High High High Webster et al., 2017 Low Low Low High High Low High High High Low Webster et al., 2018 Low Low Low High High Low High Low Low Low Webster et al., 2019a Low Low Low High High Low High High High High Webster et al., 2019b Low Low Low High Low Low High High High High Webster et al., 2020 Low Low Low High High Low Low Low Low Low Welling et al., 2020 Low Low Low High Low Low High High High High Zsidai et al., 2026 Low Low Low High Low Low High Low Low Low