Al‐Abdi 2015

Methods	Multicenter randomized (block size of 4) parallel clinical trial. Head ultrasound scan was performed within 12 hours of life, at 168 hours of life, and at the physician's discretion. Head ultrasound scan was reported by 3 radiologists who were blinded to assignment of head position. The primary analysis was by intention to treat
Participants	Preterm neonates (< 30 weeks' gestation) without intraventricular hemorrhage at 12 hours of life scan Exclusion criteria: outborn; lethal congenital anomalies; hypoxic ischemic encephalopathy; external cardiac compression or epinephrine administration at birth
Interventions	Heads of 62 preterm neonates were randomly placed in flat midline (n = 31) or flat right lateral position (n = 31) throughout the first 168 hours of life
Outcomes	The only outcome reported in the abstract was intraventricular hemorrhage
Notes	Although the planned sample size was 600 (alpha 5%; power 80%), the study was prematurely terminated owing to low accrual rate when only 71 neonates (12%) had been recruited Trial was registered on https://clinicaltrials.gov/ct2/show/NCT01584375 and findings presented at the Pediatric Academic Societies (PAS) in 2015
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method of randomization not stated
Allocation concealment (selection bias)	Unclear risk	Method of allocation not stated
Blinding of participants and personnel (performance bias) All outcomes	High risk	Unblinded intervention
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Head ultrasound scans were reported by 3 radiologists who were blinded to assignment of head position
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Low risk	Study protocol available
Other bias	High risk	Trial lacks power because only 71 infants were enrolled (instead of 600)