**2.3 Selection process**

Two reviewers independently screened the retrieve titles and abstracts. After the first screening two reviewers screened the full text independently and a third reviewer resolves disagreements when there was no consensus. All screenings were conducted by importing the search results into the Rayyan ® reference manager.

## **2.4 Clinical practice guideline quality assessment**

Three reviewers trained in the AGREE II instrument, conduct an independently quality assessment of each eligible CPG. The instrument consists of 23 items grouped in six domains. Each item receives three grades one from each reviewer directly on the online platform My AGREE Plus (http://www.agreetrust.org). The grades were considered discrepant when there was a difference of two or more points between the reviewers' grades. Discrepancies in the scoring were resolved by group discussions. For defining a high-quality CPG was used the AGREE II domain scores and a cut-off of 60% or more for 3 (rigor of development) and 6 (editorial independence) AGREE II domains [19].
