Lock 2005.

Methods	RCT
Participants	Country: USA Diagnostic tool: DSM‐IV, with some partially weight‐restored participants included, and requirement of only 1 instead of 3 missed menstrual periods No. screened: 241 No. randomised: 86, Short‐term FT: 44; Long‐term FT: 42 No. started trial: No details No. dropped out during intervention: Total: 9; Short‐term FT: 2; Long‐term FT: 7 No. dropped out during follow‐up: Total: 8; Short‐term FT: 5; Long‐term FT: 3 No. analysed: Total: 86 (at 6 and 12 months) (LOCF); Short‐term FT: 44; Long‐term FT: 42 Short‐term FT: OC BMI 37; EDE20 at 12 months Long‐term FT: OC BMI 34; EDE15 at 12 months Mean age (SD): Short‐term FT: 15.2 (1.6) years; Long‐term FT: 15.2 (1.7) years Age range in years: 12 ‐ 18 (not given by group) Gender: Total: 9 male: 77 female; Short‐term FT: 5 (11%):39 (89%); Long‐term FT: 4 (9%):38 (91%) Subtype: Short‐term FT: purging (7) 16%; restricting (37) 84%; Long‐term FT: purging (9) 21%; restricting (33) 79% Age of onset: No details Duration of illness: Total : 30% had been previously hospitalised but not stated by group whether treated or untreated; Short‐term FT: 11.3 (10.4) months; Long‐term FT: 12.0 (9.9) months Baseline weight (SD): Short‐term FT: 44.6 (5.5) kg; Long‐term FT: 46.7 (7.2) kg Baseline BMI: Total: 17.1 (1.4); Short‐term FT: 17.0 (1.3); Long‐term FT: 17.3 (1.5) Baseline eating disorder scale score (EDE eating concern): Short‐term FT: 1.35 (1.13); Long‐term FT: 1.04 (1.33) Baseline eating disorder scale score (EDE restraint): Short‐term FT: 2.76 (1.97); Long‐term FT: 2.64 (1.96) Baseline eating disorder scale score (EDE shape concerns): Short‐term FT: 2.61 (1.73); Long‐term FT: 2.41 (1.67) Baseline eating disorder scale score (EDE weight concern): Short‐term FT: 2.32 (1.51); Long‐term FT: 1.96 (1.52) Baseline purging: No details Comorbidity: Total: 36% (n = 31) had any psychiatric illness; 24% (n = 21) had MDD or DYS; 14% (n = 12) had anxiety disorder; 5% (n = 4) other Details on living arrangement: Short‐term FT: living in an ‘intact family’ 82% (n = 36); Long‐term FT: living in an ‘intact family’ 74% (n = 31) Family education/employment/income: Short‐term FT: 9% < 50 K; 33% 50 ‐ 100 K; 57% > 100 K; Long‐term FT: 10% < 50 K; 43% 50 ‐100 K; 48%, > 100 K Recruitment strategy: Recruited by referral from paediatricians and therapists to a specialty evaluation clinic for child and adolescent eating disorders Exclusion criteria: Serious medical condition (diabetes mellitus) Psychiatric illness (psychosis)
Interventions	Setting of care: Outpatient, with some hospitalised before treatment Training/qualification of care provider(s): Yes: 3 Masters Level psychologists, 1 child/adolescent psychiatrist Treatment manual: Yes: “therapists were all trained in the manual based version of family based treatment" Supervision of treatment: Yes: Weekly supervision Adherence to treatment: Unclear: “a manual based form of family based treatment was used” pg. 667(Lock 2006) Intervention group 1 Description: Short‐term family therapy Family‐based therapy but consisting of only Phase 1 and 2 (refeeding and problem‐solving for issues that interfere with refeeding) Length; 6 months Intervention group 2 Description: Family‐based therapy Labelled 'Long Term Family Therapy' in report. Consists of Phases 1, 2 and 3 Length: 12 months
Outcomes	Eating psychopathology EDE (Cooper 1987a; Cooper 1987b) Behavioural indices BMI Menstruation General Psychopathology and Obsessionality Schedule for Affective Disorders and Schizophrenia for School‐Aged Children (Kaufman 1997) YBC‐ED scale (Sunday 1995) Global pathology and interpersonal functioning Child Behaviour Checklist; Youth Self Report Checklist (Achenbach 1991) Family Functioning Family Environment Scale
Notes	Included in short family therapy vs long family therapy comparison Family therapy in both cases categorised as family‐based therapy Funded by: NIH Career Development Award
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: “randomised subjects were stratified...by duration of illness”; “ within each stratum using the Efron biased coin procedures by a research assistant not involved in assessments” pg. 634
Allocation concealment (selection bias)	Unclear risk	Quote: “randomised by a research assistant not involved in assessment to either a short or long term treatment”
Blinding of participants and personnel (performance bias) All outcomes	High risk	Therapists and participants cannot be blinded in trials of family‐based therapy
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: “assessments were conducted by trained assessors who were not involved with the treatment of patients‐not told which group that the patient was randomised to for treatment” pg. 634
Incomplete outcome data (attrition bias) All outcomes	High risk	Numbers are not reported for each group and reasons for dropout are reported but not for each group “Primary analysis was by intention‐to‐treat” for analysis for year 1 appears to include all participants, but this is not the case for long‐term outcomes ITT analysis: for year 1 but not for long‐term outcomes
Selective reporting (reporting bias)	High risk	Authors report that they collected data on family functioning, but the data are not reported in a format that is useable for analysis Authors state they collect EDE measures. However the data are not presented in a useable format, and thus the Yale‐Brown Scale was used for the eating disorder psychopathology analysis measure
Other bias	Low risk	No other problems noted