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For anxiety with chronic disease (ACD), the removal of one article (Mojtahedi et al., 2024) resulted in a substantial reduction in heterogeneity, with the I 2 value decreasing from 84% to 0%, while the treatment effect remained statistically significant, changing from SMD -0.32 (95% CI: 0.50, 0.15) to SMD -0.22 (95% CI: 0.40, 0.05)