Bilgin 2006.

Methods	Parallel randomised controlled clinical trial Randomisation ratio: 1:1 Country: Turkey Number of study centres: 1
Participants	N recruited = 70 N randomised = 70 N reported outcomes = 70 Mean age = 47.35 years Gender (m/f) = 59/11 N tube thoracostomy = 35 N VATS = 35 Inclusion criteria: Diagnosis of empyema by: chest radiograph or CT scan; pleural fluid pH, LDH, glucose and microbiological examination. Required values for pleural fluid measurements not given. Exclusion criteria: not reported
Interventions	Treatment before study: not reported Titration period and treatment: After diagnosis patients were randomised to receive either conventional thoracostomy or VATS (with fibrin debridement and saline irrigation) with subsequent thoracostomy. For both groups, pleural decortication by thoracotomy was performed if there was evidence of pleural thickening (with or without trapped lung), loculated empyema, or bronchopleural fistula. Antibiotic therapy was continued for at least 7 days (details not reported).
Outcomes	Time of outcome measurements: not reported Primary outcome(s): Length of hospital stay 8.3 (7 to 11) days (VATS) versus 12.8 (10 to 18) days (thoracostomy) Need for pleural decortication by open thoracotomy 6/35 (VATS) versus 13/35 (thoracostomy) Secondary outcome(s): Outcomes not divided into primary and secondary. Other outcome(s): not reported
Notes	Language of publication: English Publication status: peer‐reviewed journal Type of funding: not reported Conflicts of interest: none reported Stated aim for study: "We studied whether insertion of a chest tube by initially using video‐assisted thoracoscopy (VAT) results in shortening of hospitalisation time and reduces the necessity of open decortication."
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not mentioned
Allocation concealment (selection bias)	Low risk	Closed‐envelope method
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Blinding not possible
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	There were no missing outcome data.
Selective reporting (reporting bias)	Low risk	No protocol published. However, all outcomes in methods were included in results.
Other bias	Unclear risk	Funding source not reported.