Fiscella 2010.

Study characteristics
Methods	A novel approach to quality improvement in a safety‐net practice: concurrent peer review visits Patient RCT, conducted in 2 sites at a federally qualified health centre, USA Two arms: 1. Usual care (control arm) and 2. Peer review visit (intervention arm)
Participants	Control arm N: 117 Intervention arm N: 169 Diabetes type: unclear/not reported Mean age: NR ± NR % Male: NR Longest follow‐up: 12 months
Interventions	Control arm: 1) Clinician reminders Intervention arm: 1) Team changes 2) Clinician education 3) Clinician reminders
Outcomes	1) HbA1c, mean % (pre: SD, post: SE) Control arm: pre 8.8 (1.8), post 8.7 (0.2) Intervention arm: pre 9.3 (2.3), post 9.0 (0.2)
Funding source	Support was provided by The Robert Wood Johnson Foundation, Finding Answers Program
Notes	—
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "using a computer‐generated random numbers…"
Allocation concealment (selection bias)	Unclear risk	Does not describe process of allocation concealment.
Patient's baseline characteristics (selection bias)	Low risk	Age (P = 0.006), clinic site (P = 0.04).
Patient's baseline outcomes (selection bias)	Low risk	Information not available.
Incomplete outcome data (attrition bias)	High risk	Per‐protocol analysis, did not have outcome data for all participants randomised (not necessarily lost to follow‐up though?). Baseline based on those analysed.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias)	Unclear risk	Blinding of outcome assessor not discussed; objective outcome methods not described.
Selective reporting (reporting bias)	Low risk	Checked protocol and everything matches.
Risk of contamination (other bias)	High risk	Quote: "…we cannot exclude the possibility that clinician learning extended to the control group, thus biasing results to the null."
Other bias	Low risk	None identified.