Storr 1986.

Methods	Design: randomised clinical study Confirmation of methodology: not obtained
Participants	Symptomatic participants Randomly assigned: N = 138 β2‐agonists alone: 70 Combination AC + β2‐agonists: 68 Withdrawals: not reported Age: mean 5.0 years β2‐agonists alone: not reported Combination AC + β2‐agonists: not reported Gender: 95 boys (69%) β2‐agonists alone: not reported Combination AC + β2‐agonists: not reported Number of participants who received systemic corticosteroids before study enrolment: not reported Number of doses of β2‐agonists before study enrolment: not reported Number of doses of AC before study enrolment: not reported Number of participants who required supplemental oxygen before study enrolment: not reported Time from first treatment in the emergency department to enrolment in hours: not reported Eligibility criteria: All children admitted to Royal Alexandra Hospital for Sick Children (Brighton) between October 1984 and March 1985 because of asthma Exclusion criteria: Not reported
Interventions	Test group: combination AC + β2‐agonists Nebuliser with 0,25 mg ipratropium bromide with 5 mg salbutamol Control group: β2‐agonists alone Nebuliser with 5 mg salbutamol Nebulisers were given within set limits at the discretion of the nursing staff Steroids were given to children not responding satisfactorily to nebulised treatment Intravenous aminophylline was given to children in severe respiratory distress Criteria for withdrawal from study: not reported
Outcomes	Analysis: not ITT Outcomes: Duration of hospital stay: mentioned Serious adverse events: not reported Admission to ICU: not reported Need for supplemental oxygen: not reported Need for supplemental asthma therapy: mentioned Time to short‐acting β2‐agonists spaced at 4 hours: not reported Asthma severity measured as lung function Peak expiratory flow rates immediately before and 20 minutes after treatment (except at night) Asthma severity measured with a clinical asthma score: not reported Relapse within 72 hours of discharge from hospital: not reported Adverse health effects: not reported Withdrawals: not reported
Notes	Full paper (1986) Funding information not available
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Treatments were randomly allocated, but no information was provided on random sequence generation
Allocation concealment (selection bias)	Unclear risk	No adequate information was provided
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blind study
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Double‐blind study
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing data noted
Selective reporting (reporting bias)	Unclear risk	All reported outcomes were presented, but primary and secondary outcomes were not specified
Other bias	Low risk	No apparent bias was observed

AC: anticholinergics; ACA: Asthma Care Algorithm; ACA‐P: Asthma Carepath Progression; FEF_25‐75%: forced expiratory flow 25–75%; FEV₁: forced expiratory volume in 1 second; FVC: forced vital capacity; ICU: intensive care unit; ITT: intention‐to‐treat analysis; SD: standard deviation.