Ozkul 2014.

Methods	Single centre, prospective RCT comparing rapid and standard drainage prior to talc slurry pleurodesis (Turkey)
Participants	Inclusion: potentially recurrent histologically &/or cytologically proven malignant pleural effusion (all cell types) Exclusion: participants whose lung did not expand; endobronchial lesion; suitable for curative therapy 79 participants randomised
Interventions	All participants underwent insertion of a 12 Fr chest drain in the posterior axillary lune with local anaesthetic (bupivacaine) and IM ketorolac Rapid group: 1 litre drained every eight hours until complete drainage. Then talc slurry administered once CXR showed complete fluid evacuation and no trapped lung Standard group: drainage of a maximum of 1.5 litre/day. Talc slurry administered once CXR showed complete fluid evaluation and no trapped lung and pleural fluid drainage < 300 ml/day
Outcomes	Primary outcome: efficacy of pleurodesis assessed at 1, 2, 3, and 6 months Secondary outcome: hospital length of stay
Notes	people with trapped lung excluded from study entry Pleurodesis efficacy defined using a combination of radiology and symptomatic effusion re‐accumulation Not included in network meta‐analysis
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Internet‐based random‐number generator
Allocation concealment (selection bias)	Unclear risk	Not stated and no response from study authors
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not possible to blind given nature of two treatment groups with such different drainage regimes
Blinding of outcome assessment (detection bias) All outcomes	Low risk	"The assessment of success was performed by an investigator blinded to allocation"
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Unclear if any LTFU‐ not stated in paper and no response from study authors
Selective reporting (reporting bias)	High risk	Minimal data provided on side effect and mortality data. Not all time points reported as stated in methods
Other bias	Low risk	No other sources of bias identified