Ventafridda 1986.

Methods	Design: randomised, open label, parallel group study. Initial dose based on pain level and previous treatment, then titrated to adequate control Duration: 14 days Setting: home
Participants	Cancer pain, severe, uncontrolled N = 66 randomised, 54 included M 31, F 23 Mean age 55 years
Interventions	Methadone 1 mg/ml dose 4 mg ‐ 24 mg 4‐hourly, n = 27 Morphine 4 mg/ml dose 8 mg ‐ 28 mg 6‐hourly for 3 days, then 8‐hourly, n = 27 All participants received diclofenac 150 mg daily and haloperidol 20 mg/day by injection
Outcomes	PI: 5‐point categorical scale (Integrated pain score) Adverse events
Notes	Oxford Quality Score: R = 1, DB = 0, W = 0. Total = 1/5
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"randomised". 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	"not blinded"
Blinding of outcome assessment (detection bias) All outcomes	High risk	"not blinded"
Incomplete adverse event outcome data‐ patient level	Unclear risk	No denominator for data
Selective reporting bias for adverse events	Unclear risk	Presented data for days with AEs
Size	High risk	< 50 participants per treatment arm