Zaloznik 1983.

Methods	RCT of tetracycline pleurodesis versus placebo of the same pH as tetracycline (USA)
Participants	Inclusion: biopsy proven malignancy; recurrent pleural effusion; expected survival > 1 month; Karnofsky performance score ≥ 40% 30 participants randomised
Interventions	Chest tube inserted and in place for at least 24 hours. After pleurodesis agent instilled, tube clamped for two hours and participant's position changed. Then left in place for 12 ‐ 24 hours until minimal drainage Tetracycline group: 500 mg tetracycline in 50 ml saline intrapleurally. 1 dose Control group: 0.6 ml multivitamins, 5 ml of 0.1 N HCl and 50 ml saline intrapleurally. 1 dose
Outcomes	Reaccumulation of effusion on CXR at 1 month and 3 months (CR/PR/Stabilisation/progression) Side effects
Notes	CR, PR & stable disease counted as pleurodesis success for purposes of analysis Some participants with bilateral effusions entered into the study, but not clear whether both sides were randomised. Therefore for purposes of analysis, only the first side has been included Included in network meta‐analysis for pleurodesis efficacy
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not stated
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding of participants and personnel (performance bias) All outcomes	Low risk	"Double‐Blind" (no further details given)
Blinding of outcome assessment (detection bias) All outcomes	Low risk	"Double‐Blind" (no further details given)
Incomplete outcome data (attrition bias) All outcomes	High risk	Time point at which primary outcome measured not clear. Minimal data on baseline participant characteristics. Participants who died within one month excluded from analysis (11/30 not evaluable)
Selective reporting (reporting bias)	Low risk	All outcomes reported on
Other bias	Low risk	No other biases identified