Harvey 1994.

Methods	Country: United Kingdom Design: randomized controlled trial Objective: to assess acceptability and outcomes of a randomized comparison of simple aspiration vs intercostal drainage at 1 year Study site for recruitment: patients presenting to hospital Method of analysis: not reported, although logistical regression was used to measure association with failed aspiration; intention‐to‐treat data reported
Participants	Eligible for study: not reported Randomized: aspiration n = 35; tube drainage n = 38 Completed: aspiration n = 35; tube drainage n = 38 Age: aspiration mean 34.6 ± 15.0; tube drainage mean 34.6 ± 13.1 Gender: aspiration male n = 28, female n = 7; tube drainage male n = 29, female n = 9 Diagnosis criteria: patients presenting with spontaneous pneumothorax for whom the admitting team thought a drainage procedure was required Recruitment: not specifically reported, although participants presenting with spontaneous pneumothorax were randomized to either group Diseases included: not reported Reasons for patient exclusion: patients with signs of tension pneumothorax or with lung disease other than previous pneumothorax Reasons for patient inclusion: patients presenting with spontaneous pneumothorax for whom the admitting team thought a drainage procedure was required Baseline values: aspiration: previous pneumothorax n = 6; radiographic appearance: left side n = 13/30; size: small rim n = 3, partial collapse n = 16, complete collapse n = 10 Tube drainage: previous pneumothorax n = 8; radiographic appearance: left side n = 12/32; size: small rim n = 1, partial collapse n = 12, complete collapse n = 18
Interventions	Setting: not specifically reported, hospital setting assumed Aspiration description: undertaken by inserting a 16‐ to 18‐gauge catheter under local anaesthetic and aspirating air through a 3‐way tap with the exit tube under water; procedure continued until no more air could be aspirated, participant became uncomfortable, or maximum of 3 litres had been removed Chest tube description: managed according to the participating physician’s usual practice; no sclerosing drugs allowed with either technique
Outcomes	Prespecified outcomes: (1) pain experienced during procedure; (2) length of hospital stay; (3) procedure success; (4) recurrence; (5) procedure failure Follow‐up period: 12 months
Notes	No information on funding provided
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomization reported but method not described
Allocation concealment (selection bias)	Unclear risk	No mention of allocation concealment
Blinding of participants and personnel (performance bias) All outcomes	High risk	Participants not blinded
Blinding of outcome assessment (detection bias) All outcomes	High risk	Outcome assessors not blinded
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Intention‐to‐treat analysis performed; no attrition mentioned; however, information insufficient to permit a judgement
Selective reporting (reporting bias)	Unclear risk	Information insufficient to permit a judgement
Other bias	Unclear risk	Information insufficient to permit a judgement