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2019;17(11):2212-2217.e1

& Black, J

Depletion of PAPS due to lack of inorganic sulfate or due to genetic defects of enzymes participating in PAPS synthesis may lead to reducing of sulfonation capacity which could affect the metabolism of xenobiotics or disrupt the equilibrium between synthesis and degradation of active endogenous compounds

Consistently, findings from a study assessing changes in the quality of evidence in updates of Cochrane reviews indicate that only a minority of outcomes for healthcare interventions are backed by high-quality evidence (9.9%), and the quality of the evidence does not consistently show improvement or deterioration in updated reviews (251)