Annane 2013.

Methods	STUDY DESIGN: RCT Risk of Bias: HIGH
Participants	PROVIDERS: all physicians in participating ICUs PARTICIPANTS: all patients in the ICUs with sepsis. Over a 3‐year period, 62/1250 screened patients were eligible for the study, of whom 31 were randomised to each arm CLINICAL PROBLEM: sepsis SETTING: 8 hospitals in France
Interventions	FORMAT, Interventions: structural ‐ rapid testing of PCT with decision support algorithm Intervention Functions: enablement, environmental restructuring DELIVERER: departmental physician COMPARISON: usual care DESIRED CHANGE: decrease excessive POWER CALCULATION: yes, 140 participants in total (70 in each arm) would be needed (details in Appendix 3)
Outcomes	PRESCRIBING: exposure, % receiving antibiotics at day 5 CLINICAL: mortality, length of ICU stay, length of hospital stay MICROBIAL: colonisation with MRSA (nasal swab) and GNRB (rectal swabs)
Notes	FINANCIAL SUPPORT: Funding: commercial, Thermo Fisher B.R.A.H.M.S. France, a subsidiary of the maker of the PCT assay used in this study. Competing interests: none declared ADDITIONAL INFORMATION: supplementary online file has PCT algorithm, authors provided full study protocol (in French) Microbial Risk of Bias: MEDIUM (no data about infection control)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer generated
Allocation concealment (selection bias)	Low risk	Central allocation
Blinding (performance bias and detection bias) All outcomes	High risk	PCT levels not reported on control participants.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No participants lost to follow‐up.
Selective reporting (reporting bias)	Low risk	No participants lost to follow‐up.
Other bias	High risk	Study stopped prematurely because of low recruitment.
Baseline Outcomes similar?	Unclear risk	No data
Free of contamination?	Low risk	PCT levels not reported on control participants.
Baseline characteristics similar?	Low risk	Table 1