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. 2014 Dec 11;2014(12):CD009281. doi: 10.1002/14651858.CD009281.pub3

Migliardi 1994 Study 2.

Methods 6 individual studies reported, only the 2 'APAP/CAF' studies included
Both multicentre, randomised, double‐blind, placebo‐controlled, 2‐period cross‐over studies. Single oral dose taken at the onset of at least moderate headache pain to treat 2 separate attacks per treatment period (ie 4 attacks in total). At least 48 h between first and second treatment in each period, and at least a 7‐day washout period before cross‐over
4‐h study period, with assessments at baseline, 0.5, 1, 2, 3, and 4 h post‐dose
Participants Tension headache ‐ in accordance with IHS criteria and criteria established by the Ad Hoc Committee on the Classification of Headache. 6 to 7 tension headaches per month for at least 1 year that usually responded to OTC analgesics
Participants with histories of other types of headache (for example, chronic, recurrent, continuous, migraine, or post‐traumatic) were excluded
No other analgesics in the 8 h before treatment, or alcoholic beverages in the 6 h before. Caffeine was allowed before treatment, but any caffeine consumed in the preceding 4 h was noted at baseline
Participants aged 18 to 65 years
APAP/CAF Study 2:
N = 442 (423 for efficacy)
M 75, F 367
Mean age 33 years
Interventions APAP/CAF Study 2:
Paracetamol 1000 mg + caffeine 130 mg, n = 339
Paracetamol 1000 mg, n = 337
Placebo, n = 170
Outcomes PI: standard 4‐point scale
PR: standard 5‐point scale
Withdrawals and dropouts
Serious adverse events
Notes Oxford Quality Score: R1, DB2, W1. Total = 4
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not described
Allocation concealment (selection bias) Unclear risk Not described
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk "double dummy technique"
Size Low risk > 200 participants in relevant treatment arms