Data Sheet 1_Prevalence of voice disorders in military personnel: a systematic review and meta-analysis.xlsx

Prediction intervals and generalized linear mixed-model sensitivity analyses were calculated. Risk of bias and certainty of evidence were assessed using design-appropriate appraisal tools and GRADE.</p>Results<p>Sixteen studies were included in the systematic review, and 11 independent datasets from nine studies contributed to the meta-analysis. In general military populations, pooled prevalence was 3.3% (95% CI 0.2–37.5%; five datasets; n = 1,613,921; I² = 99.8%; 95% prediction interval 0.001–99.1%).

Prevalence was 40.0% in high-vocal-demand personnel (95% CI 0.8–98.2%; three datasets; n = 3,708; I² = 99.5%; prediction interval 0–100%) and 72.8% in chemically exposed cohorts (95% CI 43.3–90.4%; three datasets; n = 145; I² = 57.5%; prediction interval 0.6–99.9%). An exploratory meta-regression identified an overall subgroup association (p = 0.0300), but pairwise findings were inconsistent and statistical power was limited.

Certainty of evidence was Very Low for all three estimates.</p>Conclusions<p>Reported prevalence varies substantially across military populations and exposure contexts. Because heterogeneity was high and the certainty of evidence was Very Low, the pooled estimates should be interpreted with caution and should not be considered precise prevalence figures or evidence of causation. Standardized prospective studies are needed to quantify the occupational-health burden and evaluate targeted surveillance, prevention and early-referral approaches.</p>Systematic review registration<p>PROSPERO crd.york.ac.uk/PROSPERO/view/CRD420250640753, identifier: CRD420250640753.</p>