Abstract
This systematic review examines the efficacy of the Suzuki music teaching method in cultivating instrumental skills through experimental research. The research indicates that the Suzuki music teaching method accommodates various instruments for students of different ages but its effectiveness in enhancing rhythm skills varies with the instrument and age group. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidance, the study searched four e-databases. Seven researches were identified as eligible for final inclusion from the 481 identified literature. The included studies compared the Suzuki method to conventional music teaching methods, with the majority showing a positive effect on instrumental skills, particularly posture, musicality, and technique control. The Suzuki method is expanding its target population from children to adults, providing evidence of its effectiveness for various groups of individuals learning an instrument and proposing future research directions related to the Suzuki music teaching method.
Plain language summary
When learning to play an instrument, different teaching methods can make a big difference. One popular method is the Suzuki approach, which is like learning a language—it starts with listening and playing, rather than reading music. This study looks into how well the Suzuki method works compared to traditional ways of teaching music. We wanted to find out if the Suzuki method helps students of all ages get better at playing instruments, focusing on things like keeping rhythm, having good posture, and playing with emotion and precision. To do this, we looked at lots of studies and picked out the best ones to see what they say about the Suzuki method. What we found is pretty encouraging. Most of the time, students learning with the Suzuki method showed improvement in how they hold and play their instrument, and how they express themselves musically. The results were a bit mixed when it came to rhythm—it seems to depend on the student’s age and the instrument they’re learning.
Introduction
The Suzuki Music Teaching Method is a theory by Shinichi Suzuki of Japan which is ranked as one of the five most influential music teaching theories, including those advocated by Zoltan Kodaly, Carl Orff, Edwin Gordon and Emil Jacques-Dalcroze (Rogers & Revesz, 2019; Williamon et al., 2021). It has significantly difference from another teaching approaches in tonal development, rhythmic development, musical performance qualities, and sight reading.
However, there have been some disputes among scholars about the Suzuki music teaching method. Mehl (2009) claimed that, although Suzuki had published some related books on his “Talent Education” theory, the systematic description of his music teaching methods was mostly autobiography, anecdote, and some speeches delivered to the Music Educators National Conference. Suzuki’s music teaching method varies from mainstream music teaching methods in a class. Especially when the Suzuki method was introduced to the United States, the cultural differences between Japanese and American parents caused widespread discussion (Madsen, 1990). The most frequently cited difference between Japanese and American parents was whether parents and children were willing to listen to the teacher’s instructions without question and participate to the extent required by the Suzuki instructions (Thompson, 2016; Williams, 2000). However, it is also difficult to coordinate the relationship between parents and children to learn music. In terms of pedagogy, scholars also hold different perspectives on the validity of the Suzuki music teaching method. Hendricks (2011) argues that the Suzuki music teaching method is a rote learning approach because students must repeatedly listen to the demonstration audio until they can thoroughly memorize the melodies. Because of Suzuki’s understanding of the mother tongue, he believes that learning instrumental music is the same as knowing the native language and thus emphasizes the importance of imitation. Many scholars believe this teaching method is not conducive to developing children’s thinking ability because using behavioral learning theory to guide violin teaching is too mechanical and rigid. By only imitating the teacher’s body movement to make a sound, the students cannot develop autonomy in learning music which inhibits students’ musical perception and independent expression. Using a rote approach might be more accessible in developing performance skills. However, this teaching method may impact students’ critical thinking skills and individual performance characteristics in music, especially in teaching talented children (Haddon, 2017). Nonetheless, the Suzuki music method has been persistently implemented and refined in the instruction of various instruments, including the violin, viola, cello, bass, piano, harp, flute, and guitar. However, these differences in instructional outcomes could well be related to different experimental designs. Therefore, the delivery of classroom practice when applying Suzuki’s teaching method is less informed due to the lack of research (Thibeault, 2018).
Moorhead (2005) proposed that scholars should undertake more experimental studies related to the Suzuki teaching method to ascertain its pedagogical efficacy. However, in their systematic review, Eccles et al. (2021) identified the positive effects of musical interventions on children’s phonological awareness and early literacy skills by comparing the primary methods of music education today, namely Orff, Kodály, Suzuki, and Dalcroze. The review also noted a conspicuous dearth of experimental studies specifically related to the Suzuki teaching method, highlighting a significant gap in the empirical examination of its impact. The current study, which only examined experimental or quasi-experimental research studies pertaining to the Suzuki method, aimed to adopt a systematic review to existing experimental studies of Suzuki music teaching in order to explore their educational effects and potential problems This systematic analysis provides a more comprehensive understanding of the empirical results of Suzuki music teaching and gives us valuable references and suggestions for educational practice and future research. The research questions for this systematic review were as follows:
Does Suzuki music teaching have a significant positive effect on students’ musical skills and performance?
What are the development trends in Suzuki music teaching experimental research?
What are the challenges in designing experimental research related to the Suzuki music teaching method?
Method
Objective and Research Design
In this research, we used PRISMA to conduct items for systematic Reviews (Sarkis-Onofre et al., 2021). PRISMA was used in different fields of social science, including psychology and music education (Page et al., 2021; Tay et al., 2021). This research reviewed experimental studies related to the Suzuki music teaching method.
Information Sources and Search Strategy
In our quest to amass a comprehensive collection of pertinent literature for our study, we strategically searched four distinct databases. Initially, our exploration began with Google Scholar, a widely recognized academic literature search engine. Research indicates that Google Scholar hosts a more extensive repository of humanities and social sciences research compared to Web of Science and Scopus (Bar-Ilan, 2010; Harzing & Alakangas, 2016; Martín-Martín et al., 2018; Tay et al., 2021). Consequently, Google Scholar served as a foundational resource, providing broad access to the literature relevant to our research queries (Gusenbauer 2019). While Google Scholar excels in aggregating a large volume of literature across various document types and sources, it is important to note that its larger size does not inherently guarantee superior coverage of specific research topics (Gusenbauer & Haddaway, 2020).
To ensure a more precise and exhaustive literature review, we expanded our search to include three additional databases: Web of Science (WOS), Scopus, and ProQuest. This multifaceted approach allowed us to utilize specific keywords tailored to our research needs, thus capturing a wider and more accurate body of literature essential for systematic reviews.
The search terms employed across these databases included: “Suzuki piano teaching or Suzuki pedagogy or Suzuki method”; “Suzuki near/1 approach or talent education approach”; Suzuki and approach and (limit-to(subjarea,”psyc”)); Suzuki AND piano AND teaching*; Suzuki AND teaching OR lesson*) AND (LIMIT-TO (SUBJAREA, “SOCI”) OR LIMIT-TO (SUBJAREA, “ARTS”) OR LIMIT-TO (SUBJAREA, “MEDI”) OR LIMIT-TO (SUBJAREA, “MULT”)); Suzuki and music and “research.”
Study Selection and Data Management
A two-stage selection process was carried out according to the PRISMA methodology. In the first stage, articles were evaluated by two authors on the basis of title and abstract. Our inclusion and exclusion criteria were as follows:
Following the Table 1, this systematic review rigorously delineates the scope of literature analyzed to ensure the methodological rigor and relevance to Suzuki music instruction. The inclusion criteria were meticulously crafted to encapsulate studies that are central to the Suzuki method’s application in experimental or quasi-experimental research contexts. This focus enables a targeted exploration of the method’s impact on musical instrument proficiency, supported by quantitative data indicative of statistical significance and reliability. The exclusion criteria serve as a critical counterbalance, filtering out studies that do not meet the specified methodological standards or fall outside the review’s focused purview. By excluding studies unrelated to music instruction, those lacking in experimental rigor, or those insufficient in statistical detail, the review maintains a clear, methodologically sound basis for synthesis. Such precision ensures that the conclusions drawn are both robust and directly relevant to the field of Suzuki music education research. Furthermore, the requirement for clear methodological descriptions aids in the transparent evaluation of each study’s risk of bias, bolstering the overall quality and reliability of the review’s findings. This careful selection process, underpinned by explicit inclusion and exclusion criteria, ensures that the review contributes meaningful insights into the effectiveness of the Suzuki music teaching method, guiding future research directions with clarity and precision.
Comparative Inclusion and Exclusion Criteria for Systematic Review.
In this research, articles or papers that used quasi-experimental and experimental to examine the Suzuki music teaching method were included, while those that used qualitative research methods were excluded. To conduct a comprehensive literature search related to Suzuki theory, the researcher identified and included additional references by thoroughly reviewing the entire literature during both rounds of assessment (Gerry et al., 2012). All articles identified as eligible by at least one author in Stage One will be reassessed in Stage Two.
In the second stage, the full text of the 12 articles identified from the first stage was carefully read and evaluated by two researchers.
Sun (2023) introduced an interactive piano learning system based on the Suzuki method, utilizing a set of network applications. This system includes the Modartt Pianote app for score learning, Garritan for fine motor skill development, and regular homework completion using Native Instruments GarageBand and the WeChat mobile app. However, it’s important to note that this study lacks essential mean and standard deviation values and has been excluded as a result. Furthermore, because the key concept of the Suzuki music teaching method is to focus on developing students’ aural skills, it has been experimentally studied not only in the field of music education, but also in other medical, psychological, and human behavioral studies as a major intervention (Fujioka et al., 2004, 2006; Gerry et al., 2012; Hallberg et al., 2017; Lappe et al., 2008; Meyer et al., 2011; Shahin et al., 2004, 2008). However, in this systematic review, we only retained experimental studies that compared with other music intervention methods. For example, a proportion of studies in which the experimental group adopted the Suzuki music teaching method for the intervention, while studies in which the control group did not adopt any music-related interventions (Fujioka et al., 2004, 2006; Hallberg et al., 2017; Shahin et al., 2004, 2008) were excluded after discussion among researchers. Finally, the searched articles are entered into Endnote X9 for literature management and the results are independently cross-checked by the authors to verify their consistency and accuracy.
Data Synthesis
Due to the high heterogeneity of the included samples, a meta-analysis was not performed. Statistical analysis comparing studies with insufficient homogeneity can lead to meaningless summary results (Booth et al., 2021). In such situations, a narrative synthesis of quantitative data is frequently employed to combine diverse forms of evidence and derive comprehensive conclusions (Campbell et al., 2018).
In this system review, the data synthesis comprises three stages:
(1) developing preliminary synthesis;
(2) assessing the risk of bias in individual studies; and
(3) exploring relationships within and between studies.
Firstly, we conducted a comprehensive analysis of experimental research features in Suzuki music teaching method by extracting seven datasets from the included seven studies: Author & Date; Instrument; Number of participants; Age of participants; Variables; Grade; Duration of teaching and learning (weeks).
Furthermore, we assessed the risk of bias in the included studies to analyze the quality of experimental research designs in Suzuki music teaching method. We utilized the Cochrane Collaboration tool (Higgins et al., 2019) to evaluate potential bias at the study design. The domains evaluated consisted of random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other biases (Borenstein et al., 2021; Higgins et al., 2019). Three researchers independently assessed the procedures of each study for each domain and categorized them as “high risk,” “low risk,” or “unclear.” Discrepancies were settled through discussion among the three researchers.
Finally, to explore relationships within and between studies, we extracted data on investigated abilities and main findings from the included studies, conducting a comprehensive review of the outcomes of experimental research on the Suzuki music teaching method.
Result
The search strategy identified an initial 481 records, with seven articles meeting the eligibility criteria for final inclusion. The flowchart in Figure 1 depicts the process of identifying, screening and including articles that answered the research questions. After removing duplicates, the majority of the literature was excluded because they did not fit the experimental or quasi-experimental study design. Other reasons for exclusion included the provision of incomplete data and qualitative studies.

Search strategy used to identify researches for inclusion.
From the screening process, it can be observed that a significant proportion of the studies on Suzuki music pedagogy used observational research methods in the selection of included studies (Batubara & Wong, 2018; Bugeja, 2009; Colprit, 2000, 2003; Hendricks et al., 2021). Although these studies were not systematically reviewed because the research methods did not meet the inclusion criteria, on another level they add to the content of research related to Suzuki’s music teaching method. For example, Hendricks et al. (2021) illustrated the impact of small group sessions on empathy in Suzuki students and an exploration of family relationships. Bugeja (2009) argued that although the Suzuki method emphasizes the importance of parental education in the training of children to play, research has shown that parental involvement is high in both the traditional and Suzuki methods of teaching. Research by Batubara and Wong (2018) showed that the Suzuki music teaching method plays an important role in teaching singing skills and mastering rhythm and melody. Colprit (2000, 2003) suggested that there is a significant relationship between the quality of Suzuki violin instruction and the initiative of students to imitate specific body movements of the teacher. These studies all showed the potential of the Suzuki music teaching method to be applied in the fields of psychology, musical instruments and the performing arts such as vocal music. However, further research is needed to explore various research avenues and study directions, as experimental studies offer tangible evidence of the diverse impacts of the Suzuki music teaching method approach.
Preliminary Synthesis
The final selection was reviewed and study characteristics were collected based on the identified data items, as shown in Table 2. The researchers employed Comprehensive Meta-Analysis (CMA) V3 to examine heterogeneity within the sample. The data acquired revealed a high degree of heterogeneity (
Study Characteristics.
Risk of Bias in Individual Studies
The instrument by Cochrane Collaboration for evaluating bias risk (Higgins et al., 2019) was applied (Table 3). The studies incorporated in this analysis were primarily quasi-experimental in nature and lacked appropriate randomization sequence methods for sample selection (e.g., computer-generated random numbers or random number tables). As a result, a high or unclear risk of bias was identified in the random sequence generation process. Most studies were generally rated as low risk of bias (Chang, 1999; Kitts, 1993; Kutnu, 2020; Luna Mendoza, 2022; Stamou, 1998). As the study design of Liu et al. (2022) allocated the control and treatment groups from the same class and the report does not mention whether the subjects were aware of their grouping, the degree of risk of Allocation concealment is uncertain. There were eight subjects who withdrew from the experiment in the study by Sperti (1970), but the reasons for their withdrawal were not reported, making the control and subject groups no longer equal in size and therefore identifying a possible risk of bias in the data results.
The Instrument by Cochrane Collaboration for Evaluating Bias Risk.
Relationships Within and Between Studies
The results of relevant studies on the impact of Suzuki music teaching method on instrumental performance ability were summarized (Table 4).
Summary of Findings from Included Studies.
Discussion
The primary objectives of this systematic review are threefold: firstly, to investigate whether Suzuki music teaching exhibits a statistically significant and positive impact on students’ musical skills and performance; secondly, to identify and analyze the prevailing development trends in Suzuki music teaching experimental research; and thirdly, to assess and elucidate the challenges inherent in the design and execution of experimental research studies pertaining to the Suzuki music teaching method.
The Suzuki Music Teaching Method Has a Significant Impact on Music Skills and Performance Across Most Musical Instruments
Through this systematic review it was found that all types of Suzuki music instruction seem to have a positive effect on instrumental skills, particularly Posture, Musicality, and Technique control. In the included studies of Suzuki music instruction, teaching instruments for winds (Sperti, 1970), strings (Chang, 1999; Kutnu, 2020; Stamou, 1998) and pianos (Kitts, 1993; Liu et al., 2022; Luna Mendoza, 2022) are covered. Sperti (1970) accepted the principle of teaching by rote and scored Clarinet playing based on tone quality; technique and interpretation of the piece. Among the subjects employing the Suzuki method, 44% scored above 75.00, with scores ranging from 76.33 to 119.67 (out of a full score of 150), while the control group’s scores were significantly lower. His study showcased the effectiveness of applying the Suzuki method to instruct professional clarinet players, encompassing aspects in performance skills and style, including posture, arm control, intonation, and tone quality.
In this systematic review, the research on string (Chang, 1999; Kutnu, 2020; Stamou, 1998) and wind instrument (Sperti, 1970) yield consistent findings. Their studies collectively demonstrate the significant enhancement of comprehensive musical abilities, encompassing performance technique, stylistic expression, intonation, musicality, and auditory perception, among orchestral students (Chang, 1999; Kutnu, 2020; Sperti, 1970; Stamou, 1998). In the context of Suzuki piano instruction, three experimental studies (Kitts, 1993; Liu et al., 2022; Luna Mendoza, 2022) confirm the effectiveness of Suzuki music teaching method. However, data indicate that in the cultivation of rhythmic skills, Suzuki piano instruction appears to have a more substantial impact on adult learners (Liu et al., 2022; Luna Mendoza, 2022) compared to children (Kitts, 1993).
The Effect of Suzuki Music Teaching Method on Rhythmic Skill Development Based on Age
Through the review of included studies, we have identified a debate regarding the effectiveness of Suzuki music teaching method in cultivating rhythmic skills. Kitts (1993) investigated the rhythmic abilities of Suzuki and traditionally taught piano students, finding no significant improvement in Suzuki students’ rhythmic skills. Stamou (1998) studied violin and cello students, specifically testing rhythm. After Suzuki training, their intonation and overall scores improved, but rhythmic scores didn’t differ significantly from a control group. However, Chang (1999) offered a different perspective, emphasizing Suzuki’s unique auditory approach and its impact on students’ rhythmic abilities. All three studies focused on elementary school students aged 5 to 9, with similar durations of teaching and learning, suggesting that differences in instrumental emphasis may explain varying rhythm-related outcomes.
Nevertheless, our systematic review has revealed notable variations in the influence of the Suzuki music teaching method on students’ rhythmic abilities across distinct age groups. Within studies examining Suzuki music instruction for children, the teaching of clarinet, violin, and cello consistently exhibited positive effects on performance skills. However, when it comes to piano instruction, the Suzuki method did not manifest a significant positive impact on teaching outcomes, particularly in terms of rhythm (Kitts, 1993). This conclusion was obtained differently in the adult Suzuki music teaching experiment. Three of the included studies experimented with teaching adult students and the Suzuki method had a significant positive impact in both violin and piano (Kutnu, 2020; Liu et al., 2022; Luna Mendoza, 2022). Luna Mendoza (2022) and Liu et al. (2022) both concluded that the Suzuki piano method led to a significant improvement in the rhythmic ability of adult piano students. Liu et al. (2022) and Luna Mendoza (2022) valuated the technical and performance abilities of the Suzuki Method applied to adult piano lessons, and both demonstrated the applicability of the Suzuki Piano Method to adult music teaching. However, the difference between the two is that Liu et al. (2022) adopted an introductory level of instruction for adults, whereas Luna Mendoza (2022) proved that the Suzuki Piano Method is not only suitable for introductory piano instruction, but can also be used to improve the piano playing ability at the intermediate level. This seems to indicate that the Suzuki piano teaching method is suitable for teaching adults. Given the varying experimental durations, with Liu et al. (2022) conducting an 8-week study, Luna Mendoza (2022) covering 16 weeks, and Kitts (1993) spanning 28 weeks, it becomes challenging to disregard potential influences stemming from different experimental timeframes. Consequently, further research data are essential to establish stronger support for the positive impact on rhythm.
The Suzuki Music Instructions’ Quasi-Experimental Design Cycles Are Trending to Shorter Durations
Recent quasi-experimental studies in our analysis often involve small sample sizes and significantly shortened durations. The study by Liu et al. (2022) selected 36 subjects for 8 weeks of instruction, while the studies by Luna Mendoza (2022) and Kutnu (2020) both selected 15 or 16 subjects for 16 weeks of instruction. The two studies that were controversial in terms of rhythmic ability and reached opposite conclusions to these three studies had significantly different sample sizes and experimental periods. The study by Kitts (1993) involved 27 subjects in a 28 weeks teaching experiment, while the study by Stamou (1998) involved 100 subjects in a 22 weeks teaching experiment. The years in which these studies were conducted were far apart, and differences in the quality of teaching resources and tools may also have influenced the shortened experimental period, but there is still a need to optimize the sample size in future experimental studies. The various quasi-experimental studies exhibit factors that are challenging to control for, potentially resulting in the included studies lacking a standardized methodology for comparing distinct approaches to Suzuki music teaching method (Eccles et al., 2021).
Limitation and Recommendations for Future Studies
The current systematic review controls publication bias by using multiple large databases and by not limiting the language or date of publication. However, limited by the inclusion criteria, only studies on instrumental teaching with both the control and treatment groups were included. Consequently, by including medical studies in the systematic review (Fujioka et al., 2004; Meyer et al., 2011; Shahin et al., 2004, 2008), it might be possible to further mitigate publication bias and more effectively summarize the application of Suzuki music instruction across various fields. Certainly, although the inclusion of these studies would reduce publication bias, the heterogeneity between studies would increase further.
The Suzuki music teaching method theory highlights the important role that parents play in the music learning process (Bugeja, 2009; Einarson et al., 2022; Einfeldt, 2018). However, there seems to be little research that investigates or studies the partnership between parents and teachers. Therefore, in future studies researchers can refer to this suggestion and use parents and teachers as a research sample.
In addition, the Suzuki music teaching method, as one of the well-known music teaching methods of today, should be more globally representative of the context of such investigations (Sever, 2021). It is undeniable that the main reason why many researchers dispute the Suzuki method is because of the cultural differences between the East and the West, believing that Suzuki using a rote method is based on traditional Japanese culture and not suitable for other countries with different cultures (Madsen, 1990; Thibeault, 2018). Nearly all of the included studies were conducted in high-income countries (Kitts, 1993; Sperti, 1970; Stamou, 1998), but none of the studies asked whether being in a different income category geographically or nationally would bias the results. Therefore, future studies should consider reporting the country in which the subjects were located or including household economic income as one of the variables in the study.
Finally, adults adopting the Suzuki music teaching method for instrumental learning appear to require more theoretical support. Rooted in native language acquisition theory, Suzuki’s method has long been favored for nurturing young children’s musical abilities, improving their attention and control during instrument playing, enhancing their ability to discern timbre and pitch, and boosting their auditory memory skills. However, in recent Suzuki music teaching method research, a noticeable trend emerges over the past 3 years: the focus shifts from children (Chang, 1999; Kitts, 1993; Sperti, 1970; Stamou, 1998) to adults (Kutnu, 2020; Liu et al., 2022; Luna Mendoza, 2022). While high levels of parental involvement have presented challenges and increased experimental costs (Bugeja, 2009), the success of the Suzuki music teaching method has been contingent upon the collaborative efforts of students, teachers, and parents, forming what is commonly referred to as the “Suzuki Triangle” (Brody, 2016; Hendricks et al., 2021). However, in the three studies on adult Suzuki piano instruction, there is an absence of explicit exploration within the experimental design regarding the theoretical foundation for excluding parental involvement in quasi-experimental settings. Moreover, there is no proposal within the experimental design for alternative roles in lieu of parents, such as self-management or the application of supervisory and companionship programs. In fact, several alternative solutions have emerged to replace the traditional “Suzuki Triangle” involving parental roles (Einarson et al., 2022). For instance, Chan and Chiu (2011) designed a web-based practice support system based on Suzuki principles for busy parents. Subsequently, virtual music learning environments via social media networks started to develop. Yet, these online tools had limited functionalities, mainly providing practice alerts. However, with the rapid development of advanced online interactive tools (Carroll et al., 2021), Suzuki instructors can now offer interactive piano practice and learning environments similar to in-home education for adult learners through apps or online platforms (Sun, 2023). It effectively ensured the concentration of remote learners and, to some extent, reduced the need for family supervision and management (Einarson et al., 2022; Hendricks et al., 2021). In future research, scholars may consider designing additional instructional experiments that align more closely with Suzuki music teaching theory to enhance Suzuki music teaching method for both adults and children.
Conclusion
This systematic review meticulously examines the Suzuki music teaching method’s effectiveness in enhancing musical instrument proficiency through the lens of experimental research. Our analysis not only sheds light on current practices and trends but also underscores the critical need for a more rigorous, empirical foundation in music education research, particularly through experimental studies. A notable observation is the method’s expanded appeal, extending from children to adults, as suggested by recent studies (Liu et al., 2022; Luna Mendoza, 2022). These findings seem to indicate a growing interest in adapting the Suzuki method for adult learners. The review emphasizes the method’s core principle of parental involvement and proposes that future research could explore digital platforms and interactive programs as potential alternatives for adult education. This perspective is motivated by limited but meaningful research on digital enhancements in music learning (Carroll et al., 2021; Chan & Chiu, 2011).
Moreover, this review encourages for experimental studies that probe the Suzuki method’s adaptability across diverse cultural and economic landscapes. Future research might incorporate a wider array of demographic and economic backgrounds to enrich our understanding of the method’s global relevance.
Footnotes
Acknowledgements
The authors would like to extend their sincere thanks to editor and anonymous reviewers for their insightful feedback during the review process.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Ethical Approval
Not applicable in this study since this study was not interventional in nature.
Data Availability Statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
