Anderson 2009.

Methods	Randomised, cross‐over trial with 2‐month interventions. Measurements were taken at 0, 2, 4 months. Generation of allocation schedule and concealment of treatment allocation were unclear. ITT analysis was not used.
Participants	8 stable children randomised (mean 11 years, range 8 ‐ 14 years) mean FEV1 81% (range 63% ‐ 98%). Dornase alfa maintenance via eFlow rapid. There were 3 withdrawals due to exacerbations, time of withdrawal not stated.
Interventions	Delivery before airway clearance techniques compared to delivery after airway clearance. Times in relation to ACT (PEP or AD) unclear. No placebo or washout. Maintenance DNase.
Outcomes	FEV1, QOL (Bespoke subjective questionnaire), FEF25.
Notes	Further data obtained from author. PEDro 3/10 (Eligibility criteria: yes; random allocation: yes; concealed allocation: no; baseline comparability: yes; blind participants: no; blind therapists: no; blind assessors: no (because not clearly stated); adequate follow‐up: no; ITT analysis: no; between‐group comparisons: yes; point estimates and variability: no).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomised for 18 participants who were identified as potential participants, 8 were subsequently enrolled. The method of randomisation was not described.
Allocation concealment (selection bias)	High risk	Information from the author suggests the assessor was aware of the allocation sequence.
Blinding (performance bias and detection bias) All outcomes	High risk	No placebo. Unclear if the assessor blinded.
Incomplete outcome data (attrition bias) All outcomes	High risk	Not ITT. Unclear from which group the 3 dropouts occurred.
Selective reporting (reporting bias)	Low risk	QOL was reported as non‐significant in the publication but data were not provided by authors.