Panich 1993.

Methods	Design: randomised, single blind, two‐phase cross‐over study Duration 2 x 7 days, no washout Setting: Pain clinic in Thailand
Participants	Severe cancer pain N = 73 (49 reported) Mean age 53 years (± 10) Weight 46.5 kg (± 10.6)
Interventions	Mm/r 10 mg or 30 mg 12‐hourly MIR solution (local formula) 5 ‐ 10 mg 4‐hourly Paracetamol or narcotic injection for breakthrough pain
Outcomes	Nurse assessment of pain: VAS Nurse assessment of sleep duration: 4‐point categorical scale Participant preference 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	"randomised into 2 groups" 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	Single blind ‐ nurse blinded
Blinding of outcome assessment (detection bias) All outcomes	High risk	Single blind ‐ nurse blinded
Incomplete adverse event outcome data‐ patient level	High risk	<90% participants included
Selective reporting bias for adverse events	High risk	Selective reporting
Size	High risk	< 50 participants in each treatment arm (for analysis reported)