Vaisman 2008.

Study characteristics
Methods	Design: parallel trial Comparator: omega‐3 PUFA vs placebo
Participants	Inclusion criteria: 1. aged 8 to 13 years; 2. had received a previous diagnosis of ADHD by a clinical psychiatrist, neurologist, or paediatrician Exclusion criteria: 1. significant sensory or neurological limitations; 2. epilepsy; 3. mental retardation; 4. psychosis; 5. pervasive developmental disorder; 6. taking medications with known central nervous system effects (including stimulants or dietary supplements other than vitamins); 7. a total Test of Variables of Attention Score more than 1.8 SD lower than age and gender means Number of participants: 60 Mean age: 9.3 years Gender: 45 boys and 15 girls at follow‐up ADHD subtypes: not stated Using ADHD drugs at baseline: 0% Baseline scores: Conners Rating Scale: PUFA = 15.8; placebo = 15.1 Setting: medical centre in Tel Aviv, Israel, 2004 to 2005 Funding: not stated
Interventions	Intervention (39 participants): PUFA for 3 months Phospholipid supplement enriched with n‐3 fatty acids (Enzymotec Ltd, Israel) containing 95 mg of DHA, 156 mg of EPA, 300 mg of phosphatidylserine, rosemary extract, ascorbyl palmitate, and mixed natural tocopherols (0.8% by weight), emulsified to a dairy chocolate‐flavoured spread containing 4 to 7 mg of citrus oil extract (to disguise taste) administered daily as 25 g of spread Fish oil supplement (Ocean Nutrition) containing 96 mg of DHA, 153 mg of EPA and tocopherol mixture (0.2% by weight) daily, emulsified to a dairy chocolate‐flavoured spread containing 4 to 7 mg of citrus oil extract (to disguise taste) administered daily as 25 g of spread for 3 months Control (21 participants): placebo for 3 months; rapeseed oil supplement emulsified to a dairy chocolate‐flavoured spread containing 4 to 7 mg of citrus oil extract, administered as 25 g of spread per day for 3 months
Outcomes	Symptoms at 3 months Change in parent‐rated abbreviated Conners Rating Scale
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Comment: A block randomisation with a block size of 3 was used.
Allocation concealment (selection bias)	Unclear risk	Comment: Allocation concealment was not described.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Comment: The supplements appeared "identically appearing" (p1172); therefore, participants were probably blinded.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Comment: The supplements appeared identical and a parent‐rated scale was used.
Incomplete outcome data (attrition bias) All outcomes	High risk	Comment: A per protocol analysis was used for 60 of 83 participants.
Selective reporting (reporting bias)	Low risk	Comment: all outcomes listed in paper and protocol appear to have been reported
Other bias	Unclear risk	Comment: The principal author was a consultant to Enzymotec Pty Ltd and the Director was another author.