Review of: "Effect of Clown Therapy on Symptoms and Emotions of Children with Neoplastic Disease: A Systematic Review with Meta-Analysis"

This systematic review and meta-analysis addresses an important and often underexplored aspect of pediatric oncology care by evaluating the effectiveness of clown therapy as a nonpharmacological intervention for symptom and emotional management in children with neoplastic disease.The manuscript demonstrates several notable strengths, particularly its adherence to established methodological standards, including PRISMA reporting, PROSPERO registration, Cochrane RoB 2 bias assessment, and application of the GRADE framework to evaluate evidence certainty.The search strategy is comprehensive and multidisciplinary, covering a broad range of international databases and trial registries without language or date restrictions, which reduces the likelihood of selection bias and enhances transparency.Additionally, the authors provide clear outcome de nitions and appropriate statistical techniques, including standardized mean difference calculation, heterogeneity analysis, and sensitivity considerations, supporting the methodological robustness of the quantitative synthesis.