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Fig 1.

PRISMA flow diagram.

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Table 1.

Characteristics of included studies.

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Table 1 Expand

Table 2.

MERSQI scores of included studies.

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Table 3.

Type of analysis and LLM evaluated for each outcome.

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Fig 2.

(a) Forest plot of network meta-analysis for question relevancy. (b) Forest plot of single-arm analysis for question relevancy.

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Fig 3.

(a) Forest plot of network meta-analysis for question clarity. (b) Forest plot of single-arm analysis for question clarity.

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Fig 4.

(a) Forest plot of network meta-analysis for distractor quality. (b) Forest plot of single-arm analysis for distractor quality.

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Fig 5.

(a) Forest plot of pairwise analysis for question accuracy. (b) Forest plot of single-arm analysis for question accuracy.

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Fig 6.

(a) Forest plot of pairwise analysis for question difficulty index. (b) Forest plot of single-arm analysis for question difficulty index.

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Fig 7.

(a) Forest plot of pairwise analysis for item discrimination index. (b) Forest plot of single-arm analysis for item discrimination index.

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Fig 8.

(a) Forest plot of pairwise analysis for point biserial correlation. (b) Forest plot of single-arm analysis for point biserial correlation.

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