Fitzgerald 2005.

Methods	Randomised, blinded, cross‐over placebo‐controlled trial with 2‐week interventions and 2‐weeks washout. Measurements were taken at 0, 2, 4 and 6 weeks. Generation of allocation schedule and concealment of treatment allocation were clear. ITT analysis was used.
Participants	52 stable children randomised; mean (SD) age 10.7 (3.2) years; mean (SD) FEV1 83 (18) % predicted. There were 2 withdrawals due to protocol violations (1 nebulisation instead of 2) in the second arm while inhaling dornase alfa after airway clearance.
Interventions	Delivery 30 minutes before airway clearance techniques compared to delivery 30 minutes after airway clearance. ACT = 'physiotherapy' or PEP mask. DNase naive.
Outcomes	FEV1, FVC, QOL (composite QWB). VO2max (Shuttle), FEF25‐75, adherence (vials returned), adverse events (34 in 26 participants including diverse symptoms ‐ intervention group unclear).
Notes	Subgroup analysis FEV1 for those with Pseudomonas aeruginosa in the preceding 2 years (n = 17) PEDro 9/10 (Eligibility criteria: yes; random allocation: yes; concealed allocation: yes; baseline comparability: no; blind participants: yes; Blind therapists: yes; blind assessors: yes; adequate follow‐up: yes; ITT analysis: yes; between‐group comparisons: yes; point estimates and variability: yes).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Block randomisation by an independent investigator was used.
Allocation concealment (selection bias)	Low risk	Independent distant pharmacy.
Blinding (performance bias and detection bias) All outcomes	Low risk	Placebo used; participants, therapists and assessors blinded.
Incomplete outcome data (attrition bias) All outcomes	Low risk	2 participants did not take both medications in the second arm.
Selective reporting (reporting bias)	Low risk	QOL, VO2max, FEF25‐75 and adverse events and were reported as non‐significant in the publication but data were not provided by authors.