Barst 1996.

Methods	Randomised, parallel‐group, open‐label trial
Participants	Primary pulmonary hypertension who were NHYA III or IV despite optimal treatment (which included anticoagulants, oral vasodilators (68% in each group), diuretic agents, cardiac glycosides, and supplemental oxygen n = 81
Interventions	Intravenous epoprostenol (flolan) versus conventional therapy mean max dose of epoprostenol was 9.2 + 0.5 ng/kg/min
Outcomes	6MWD, cardiopulmonary haemodynamics, Chronic Heart Failure Questionnaire, Dyspnoea Fatigue Rating, clinical worsening (transplantation), adverse events, mortality Outcomes measured at 12 weeks
Notes	Partly industry funded and partly publicly funded ‐ "Supported in part by Burroughs Wellcome, Research Triangle Park, N.C. Dr.Rubin is the recipient of an academic award in vascular disease from the National Heart, Lung, and Blood Institute. Dr. Badesch is the recipient of a clinical investigator award from the National Institutes of Health".
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	A computer‐generated, adaptive randomisation was performed, with stratification according to the functional class, study centre, and baseline vasodilator use
Allocation concealment (selection bias)	Unclear risk	Not clear
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open‐label study
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Unclear
Incomplete outcome data (attrition bias) All outcomes	Low risk	Dropouts reported
Selective reporting (reporting bias)	Low risk	All outcomes were reported
Other bias	Low risk	Other bias unlikely