Zhang 2008.

Study characteristics
Methods	Design: RCT, parallel three‐arm, single‐centre hospital Setting: regional hospital, Zhenhai, Ningbo, China Recruitment: March 2005 to December 2006 Maximum follow‐up: 48 hours postoperatively
Participants	60 participants undergoing orthopaedic procedures were randomly allocated to one of three groups: Group 1(Platelet‐rich plasmapheresis + autotransfusion group): n = 20 Group 2(Simple autologous blood) (cell salvage/intervention group): n = 20 Group 3 (Untreated group) (control/no cell salvage group): n = 20 Demographic data not reported for each trial arm.
Interventions	Group 1(Platelet‐rich plasmapheresis + autotransfusion group): platelet‐rich plasmapheresis group received platelet‐rich plasma (PRP)and autotransfusion with the use of the Haemonetics Cell Saver 5 system. Group 2(Simple autologous blood) (cell salvage/intervention group): autotransfusion group received intraoperative autotransfusion of shed blood using the Haemonetics Cell Saver 5 system. Group 3 (Untreated group)(control/no cell salvage group): control group received standard care without PRP and autotransfusion.
Outcomes	Outcomes reported: number of participants transfused allogeneic blood, blood loss
Notes	Transfusion protocol: the use of a transfusion protocol is not reported within the translated article. Prospective registration status: the study was published prior to 2010. Ethical approval: it is unclear whether the study was approved by an ethics committee or institutional review board. Language of publication: Chinese Study groups: for the purpose of our review, the comparison of interest is Group 2 (autotransfusion only) versus Group 3 (untreated group). Trial funding: not reported Conflicts of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method used to generate allocation sequences was unclear (translation).
Allocation concealment (selection bias)	Unclear risk	Method used to conceal treatment allocation was unclear (translation).
Blinding of participants and personnel (performance bias) Objective outcome: mortality	Low risk	No objective outcomes reported (mortality unlikely to be affected by blinding if reported in future publications)
Blinding of participants and personnel (performance bias) Subjective: transfusion protocol	High risk	No transfusion protocol in place (translation)
Blinding of participants and personnel (performance bias) Subjective: all other outcomes	Unclear risk	No protocols; no blinding (translation)
Blinding of outcome assessment (detection bias) Objective outcomes: mortality and transfusions	Low risk	No objective outcomes reported (mortality unlikely to be affected by blinding if reported in future publications)
Blinding of outcome assessment (detection bias) Subjective outcomes	Unclear risk	No protocols; no blinding (translation)
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	60 analysed, but no info on number randomised, or any protocol violations (translation)
Selective reporting (reporting bias)	Unclear risk	No trial registration or published protocol is available to compare
Other bias	Unclear risk	No baseline imbalance (there was no significant difference in age, weight, gender composition amongst the 3 groups (P > 0.05)). No mention of funding or conflicts of interest in translation