Thieme 2003.

Methods	RCT; 2 arms; assessed at pre‐treatment, post‐treatment, 6 months, 15 months
Participants	End of treatment n = 61 Start of treatment n = 83 Sex: 61 F, 0 M Mean age = 47.3 (SD 8.3) Source = hospital for rheumatic disorders Diagnosis = fibromyalgia Mean years of pain = 16.5
Interventions	"operant treatment" "standard physical treatment"
Outcomes	Primary pain outcome: MPI pain Primary disability outcome: MPI interference Primary mood outcome: MPI affective distress Catastrophising outcome: none Diary pain intensity Multidimensional Pain Inventory: pain Multidimensional Pain Inventory: interference Multidimensional Pain Inventory: life control Multidimensional Pain Inventory: affective distress Multidimensional Pain Inventory: social support Multidimensional Pain Inventory: self efficacy Multidimensional Pain Inventory: punishing responses, solicitous responses, distracting responses Multidimensional Pain Inventory: total activities Doctor visits (from medical records) Hospital days (from medical records) Sleep hours diary Medication diary Tubingen pain behaviour scale
Notes	BT versus TAU, post‐treatment and follow‐up: analyses 7.1, 7.2, 7.3, 8.1, 8.2, 8.3 Yates quality scale: total quality = 15/35, design quality = 11/26, treatment quality = 4/9
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	“randomly assigned”
Allocation concealment (selection bias)	High risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Attrition reported; no test for differences
Selective reporting (reporting bias)	Low risk	Fully reported
Blinding of outcome assessment (detection bias) All outcomes	High risk	Not reported