Flöter 1997.

Methods	Design: randomised, open label, parallel group study. Initial 7 ‐ 14 day titration with Kapanol or Mm/r Duration: 14 days + titration phase Setting: in‐ and outpatient
Participants	Mixed pain: 27/91 Kapenol and 26/74 MST had cancer pain N = 165 M 98, F 67 Mean age 55 years Weight 69 kg
Interventions	Kapanol (20 mg, 50 mg or 100 mg) 12‐hourly, n = 91 Mm/r (10 mg, 30 mg, 60 mg, or 100 mg) 12‐hourly, n = 74 Paracetamol, NSAIDs, antidepressants allowed; advised not to alter. Other opioids not permitted Rescue medication: MIR 10 mg
Outcomes	PI: VAS (physician assessment of pain control) Quality of sleep Rescue medication Well being etc (patient diary) Adverse events
Notes	Oxford Quality Score: R = 2, DB = 0, W = 1. Total = 3/5
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"randomisation performed using a random number generator"
Allocation concealment (selection bias)	Unclear risk	Method not described
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open
Blinding of outcome assessment (detection bias) All outcomes	High risk	Open
Incomplete adverse event outcome data‐ patient level	Low risk	> 90% of participants included
Selective reporting bias for adverse events	Unclear risk	No details of specific AEs
Size	Unclear risk	50 ‐ 200 participants per treatment arm