Finn 1993.

Methods	Design: Randomised, double blind (double dummy), two‐period cross‐over study Duration of study: 6 days (day 1: usual MIR; days 2 and 3 either Mm/r or MIR (with matched placebo); days 4 and 5 cross‐over) Setting: outpatients
Participants	Cancer pain requiring > 60 mg MIR/daily N = 37 (34 completed) Mean age 59 years
Interventions	Mm/r: 30 mg 12‐hourly MIR 20 mg/ml 4‐hourly Dose adjustment allowed Non‐opioid medications continued Rescue medication: paracetamol, MIR or sub‐cut/IM morphine
Outcomes	PI: VAS x 3 daily, and 4‐point categorical (Karnofsky) Adverse events Use of rescue medication Participant preference
Notes	Oxford Quality Score: R = 2, DB = 2, W = 1. Total = 5/5
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"randomisation by using randomisation schedule provided to the responsible pharmacist"
Allocation concealment (selection bias)	Unclear risk	Method not described
Blinding of participants and personnel (performance bias) All outcomes	Low risk	"blinded drug supplies packaged daily by the responsible pharmacist"
Blinding of outcome assessment (detection bias) All outcomes	Low risk	"blinded drug supplies packaged daily by the responsible pharmacist"
Incomplete adverse event outcome data‐ patient level	Low risk	> 90% of participants included
Selective reporting bias for adverse events	High risk	Only selected AEs reported
Size	High risk	< 50 participants per treatment group