In Reply We thank Zhang and colleagues for their appraisal of our work.1 Regarding the first point, it appears that the authors have misinterpreted our statistical analysis. The authors state that our methods included the following sentence, “For each analysis, we included the 95% CIs, I2 statistic, τ2 statistic, and χ2; all tests were 2-sided, and a P value <.05.” In the methods section of our article, the following 2 separate sentences can be found, “For each analysis, we included the 95% CIs, I2 statistic, τ2 statistic, and χ2. All tests were 2-sided, and a P < .05 was considered significant unless otherwise indicated.”1 The first sentence regarding heterogeneity metrics is unrelated to the second sentence highlighting that P < .05 was used to assess significance among the efficacy outcomes. In our protocol (), we prespecified that heterogeneity was going to be assessed by I2; however, as Zhang et al notes, no threshold was set. Applying an a posteriori threshold of I2 greater than or equal to 50% as representing substantial heterogeneity, which aligns with the Cochrane handbook,2 none of the primary analyses conducted had substantial heterogeneity. Therefore, we do not believe that heterogeneity affects the interpretation of these results or requires further exploration.