Cho 2004.

Study characteristics
Methods	Study design Parallel RCT Study dates Duration of follow‐up: 4 weeks Time frame: not reported
Participants	Study characteristics Setting: multicentre (2 HD clinics in major hospitals in Tainan, Chi Mei Medical Center) Country: Taiwan Inclusion criteria: HD patients with complaints of fatigue; ≥ 18 years; rational and able to communicate in Mandarin or Taiwanese; written consent to participate in the study; receiving routine HD treatment for at least 3 months Exclusion criteria: DSM IV psychiatric diagnoses: severe complications during dialysis; other severe diseases such as cancer Baseline characteristics Number (analysed/randomised): intervention group (28/31); control group (30/31) Mean age ± SD (years): intervention group (45.1 ± 9.70); control group (53.7 ± 8.51) Sex (M/F): intervention group (8/20); control group (17/13) Dialysis type: HD Mean dialysis vintage ± SD (years): intervention group (4.95 ± 3.54); control group (4.72 ± 3.88) Comorbidities CVD: not reported Diabetes: not reported Hypertension: not reported Depression (clinician diagnosis): not reported
Interventions	Intervention classificaiton Non‐pharmacological intervention Indication: study targeting fatigue Intervention group Acupressure Control group No intervention Co‐interventions Not reported
Outcomes	Outcomes reported Fatigue outcome measures used: validation data available Fatigue Chinese version of the PFS assessed pre‐ and post‐test Behavioural/severity Affective meaning Sensory Cognitive/mood Depression Chinese version of the BDI: assessed pre‐ and post‐test
Notes	Additional information Funding: not reported Conflicts of interest/disclosures: not reported Trial registration identification number: not applicable A priori published protocol: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Patients were then assigned randomly to either experimental or the control group. [...] There were no differences in demographic data between the groups (p > 0.05). However, a significant difference in age (p < 0.05) was found between groups." Comment: Sequence generation methods were not reported in sufficient detail to permit judgement
Allocation concealment (selection bias)	Unclear risk	It was not stated if the enrolling investigator (project director) had knowledge of the forthcoming allocation. Although there were some differences between groups, these differences did not suggest a problem with the randomisation process
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not reported. However, interventions were different and participants and/or investigators could be aware of the treatment assigned
Blinding of outcome assessment (detection bias) All outcomes	High risk	The outcomes were assessed with an appropriate measure, without differences between groups. However, subjective measures were used, it was not stated whether outcomes were assessed without knowledge of treatment allocation, and knowledge of treatment assignment may have influenced reporting. Participant beliefs about the superiority/inferiority of either intervention could have influenced their assessment of the outcome, but there was no evidence that this was likely. However, other subjective outcomes were reported
Incomplete outcome data (attrition bias) All outcomes	High risk	Quote: "62 cases were recruited to this study and 3 cases in the experimental and 1 case in the control group dropped out. [...] The reasons for dropping out were relocation or being transferred to other dialysis centre." Comment: 28/31 participants in the intervention group and 30/31 participants in the control group completed the study (> 5% lost to follow‐up, with differences between group). Reasons for discontinuations seemed to be not related to the treatment allocation
Selective reporting (reporting bias)	High risk	Information about the protocol and the statistical analysis plan was not reported. Fatigue was reported using multiple eligible outcome measurements (scales, time points). Fatigue was reported in a format that was extractable for meta‐analysis. All outcomes that should be addressed (fatigue, cardiovascular disease, and death) were not reported
Other bias	Unclear risk	Although there were some differences between groups, there was no substantial evidence of different baseline characteristics, or different non‐randomised co‐interventions between groups. Funding and conflicts of interest were not reported