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  \section{Results}  Our overall dataset included 337 studies during just the identification process of articles (Figure 1). From that initial dataset 79 articles were excluded during the screening process due to the fact that they were neither meta-analyses nor systematic reviews. The remaining set of articles that were assessed for meeting our eligibility criteria was 258. An additional 76 studies were removed after individual and group consensus was reached about reasons to remove those articles from our dataset. The studies removed were genetic studies, individual patient data meta-analyses, genomic studies, histological studies, and a letter to an editor. Our final dataset contained 182 articles.   Within this data set, quality or risk of bias assessment was conducted in 91 articles (50 percent) \ref{fig:FIGURE_3}. Most common tools used were those adapted from other sources (24.47 percent, n=25/91) such as other authors \ref{fig:FIGURE_6}.  The second highest used  tools were those in which the author independently assessed (20.88 percent, n=19/91) and those  that were unspecified (13.19 percent, n=12/91) \ref{fig:FIGURE_6} \ref{fig:FIGURE_7} . QUORUM was the fourth highest used tool in Oncology Journals and was used 12.09 percent, n=11/91 \ref{fig:FIGURE_6}.  In assessing risk of bias, high/medium/low scale was  used most commonly (18.97 percent, n=11/58) followed by high/medium/unclear (13.79 percent, n=8/58), and quality was assessed through author created scales (29.31 percent, n=17/58) and the Jadad scale (15.52 percent, n=9/58) \ref{fig:FIGURE_8} \ref{fig:FIGURE_9}. Low Quality or High risk of bias studies  were those found in 46 studies out of the 91 studies that  assessed by quality \ref{fig:FIGURE_10. There were 37 studies in which it could not be determined whether Low Quality or High Risk of Bias studies were isolated \ref{ig:FIGURE_11} \ref{fig:FIGURE_12}.   There were 35 studies in which low quality or high risk of bias were found and included with 76.09 percent (n=35/46) \ref{fig:FIGURE_14}.From included studies, subgroup analysis was conducted in 17.58 percent n=16/91) \ref{fig:FIGURE_15}. Meta regression was used to address bias and quality problems in 8.79 percent of  the author independently 46 articles that assessed quality \ref{fig:FIGURE_16}. Sensitivity analysis was used to address bias and quality reporting issues in 17.58 percent of studies analyzed \ref{fig:FIGURE_17}.   Quality measures were articulated largely in narrative format (47.25 percent, n=43/91) or not at all (39.56 percent, n=36/91). Additional forms of presentation included combinations of figures and narratives (4.40 percent, n=4/91) \ref{fig:FIGURE_18}. The combination of table and narrative was also used moreso than single formats of presentation (3.30 percent, n=3/91) \ref{fig:FIGURE_18}.  \section{Discussion}    \section{Discussion}  \section{Acknowledgements} \section{Conclusion}   
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