Bibliographic information Overall rating	Study* Category (points deducted)	Practice* Category (points deducted)	Outcome measures* Category (pts deducted)	Results/findings* Category (points deducted)
– Author(s): Raisky, F; Gauthier C; Marchal, A; Blum, D.  – Year: 1994  – Publication: Ann de biologie clinique  – Affiliations: CHG Louis-Pasteur, Dole Cedex, France  – Funding: Internal	– Design: (0) Random Assignment experiment – Facility/setting: (0) Hospital ED in France — No other description – Time period: (0) July and August, 1992 – Population/sample: (1) 350 (195 f and 155 m) aged 1–95. Any patient undergoing blood sampling and infusion in the ED. Randomized by number sheet in blocks of 6. Post-exclusion for non-standard sampling (N=45), missing or insufficient tube (N=6), pathological interference with measuring hemolysis (N=4). Final N: Needle-95; IV starts: 100+100. – Comparator: (0) 1) Straight needle vs. IV start. Also evaluated two types (Teflon and Vialon) of catheters. – Study bias: (0) None observed — usual practice introduced confounding by location, needle size.	– Description: (0) Very detailed with brand names of all parts of systems. Full protocol including order of tubes provided. Straight needle: antecubital site in 85.3%, 20 g needle in 74.8% (also 21 & 22 g) Catheter: antecubital site in 6%, forearm in 73–77%, 18 g in 83–90% (also 20 & 16 g) All samples collected in 5 mL glass vacuum tubes. Groups comparable in age and gender (tests for randomness). All data recorded on randomization form. – Duration: (0) July and August, 1992 – Training: (0) None – Staff/other resources: (0) Minimal — used standard collection conditions – Cost: (0) Not reported.	– Description: (0) Hemolysis determined by both visual and calibrated automatic photometric reader (detection limit of 0.05 g/l of plasma). Hemolysis status of patient determined by the tube used for electrolytes and enzymes — tests most sensitive to hemolysis. – Recording method: (0) Data collected on randomization form which was sent to lab with sample. Lab blinded to status.	– Type of findings: (0) Rates of hemolysis – Findings/effect size: (0) Final N=853. Straight needle vs. IV start: 11/95 (11.6%) vs. 97/200(48.5%) For the two catheters: Teflon: 42/100 (42%) Vialon: 55/100 (55%) – Statistical significance/test(s): (0) ANOVA by ranks — Kruskal–Wallis (non-parametric). Note: all comparisons between groups (3-way and pairwise) had significance of pb0.00001 – Results/conclusion biases: (0) Randomized subject assignment to collection technique. Very detailed description of protocol and testing methods. No biases observed, although conclusion is tempered by differences in site and needle gauge for the two compared techniques
Quality rating: 9 (good)  Effect rating: SubstantialRelevance: Direct	Study (3 max): 2 Although randomized, clear differences in site and gauge by method.	Practice (2 max): 2	Outcome (2 max): 2	Results/findings (3 max): 3

^*Numbers in () by category headings reflect the number of points deducted from the maximum points for that column domain.