Oztürk 2008.

Methods	Design: randomised, open label, parallel group study Duration: 15 days Setting: hospital and home
Participants	Lung cancer requiring WHO step 3 opioids for pain; 18 of fentanyl patients were treated in hospital, and 16 of morphine patients were treated in hospital, others were visited by doctors at home N = 50 M/F not reported Mean age 55 years (completers, range not stated)
Interventions	Transdermal fentanyl (TDF) patch Sustained relief oral morphine Starting level: Participants requiring 200 to 400 mg tramadol used 25 μg/h TDF patches Participants requiring 500 to 600 mg oral tramadol used 50 μg/h TDF patches 120 mg slow release morphine Dose increased if inadequate response to maximum 100 mg/h TDF or 180 mg Mmr(41% and 23% changed, two participants in each group increased dose twice) Rescue medication: both groups given subcutaneous morphine if pain ‘unbearable’ (NRS > 3)
Outcomes	Pain: NRS (0‐10) Activities of daily living: Eastern Cooperative Oncology Group Adverse events
Notes	Oxford Quality Score: R = 1, DB = 0, W = 1. Total = 2/5
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method used to generate sequence not clearly stated
Allocation concealment (selection bias)	Unclear risk	Method not described
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open study
Blinding of outcome assessment (detection bias) All outcomes	High risk	Open study
Incomplete adverse event outcome data‐ patient level	Low risk	>90% participants included
Selective reporting bias for adverse events	High risk	Selective reporting
Size	High risk	< 50 participants per treatment arm