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(e) cross-sectional studies with no time restriction, (f) only studies published in English were included due to resource limitations and to ensure accuracy in data extraction and risk-of-bias assessment

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24 In a clinically symptomatic patient with specific features of B 12 deficiency, order a B 12 test, see Figure1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non- Specific** or Specific Symptom of B 12 Deficiency for more detail