Kumar 2015

Methods	Study design: parallel‐group randomised controlled trial. Setting: single centre/India. Dates when study was conducted: March 2012 to September 2013.
Participants	Inclusion criteria: age < 15 years and single radio‐opaque lower calyceal calculus 1‐2 cm. Exclusion criteria: bleeding disorders, radiolucent stones, active urinary tract infection, severe hydronephrosis, unfit for anaesthesia, serum creatinine > 1.5 mg/dL, anatomically abnormal kidney and co‐existing ureteral pathology including tumour/stricture. Diagnostic criteria: USS KUB, radiography of the KUB to assess radiopacity of the calculus, IVU. CT in some cases to assess the pelvicaliceal anatomy including lower caliceal infundibulopelvic angle, degree of hydronephrosis, and urinary drainage pattern. Total number of participants randomly assigned: 221. Group A (SWL) Number of participants randomly assigned: 111. Age (mean): 10.7. Gender (M/F): 52/54 finished trial. Group B (Mini PCNL) Number of participants randomly assigned: 110. Age (mean): 10.3. Gender (M/F): 51/55 finished trial.
Interventions	Group A (n = 111): SWL (5 patients lost to follow‐up (106 included in analysis). Outpatient procedure using the electromagnetic lithotripter (Dornier Alpha Compact system, Wessling, Germany). Shockwave delivery rate 90 pulses per minute. Group B (n =110): Miniperc (4 patients lost to follow‐up (106 included in analysis). One experienced consultant and under general anaesthesia. Co‐interventions: double J stent and nephrostomy in PCNL.
Outcomes	Stone clearance How measured: KUB radiography. Time points measured: 3 weeks after surgery. Time points reported: not reported. Subgroup: none. Complications How measured: perioperative evaluations, some not reported. Time points measured: some during surgery, some not reported. Time points reported: not reported. Subgroup: none. Secondary procedures How measured: KUB radiography. Time points measured: 3 weeks after surgery. Time points reported: not reported. Subgroup: none.
Notes	Funding Sources: not stated Declaration of interests: no competing financial interests exist.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote from publication: 'Using a computer generated randomisation table, the eligible patients were randomised into two groups: Groups A, patients who underwent mini‐perc, and group B, patients who underwent SWL.'
Allocation concealment (selection bias)	Unclear risk	Not described by the authors. No clarification regarding open or concealed randomisation schedule.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not described.
Blinding of outcome assessment (detection bias) Subjective outcomes	Unclear risk	Not described.
Blinding of outcome assessment (detection bias) Objective outcomes	Low risk	Objective outcomes are not likely to be influenced by lack of blinding.
Incomplete outcome data (attrition bias) Stone free rate	Low risk	5/111 (4.5%) and 4/110 (3.6%) participants in SWL and mini‐PCNL group were not included in the analysis, respectively.
Incomplete outcome data (attrition bias) Serious adverse events or complications of treatment	Low risk	5/111 (4.5%) and 4/110 (3.6%) participants in SWL and mini‐PCNL group were not included in the analysis, respectively.
Incomplete outcome data (attrition bias) Secondary procedures	Low risk	5/111 (4.5%) and 4/110 (3.6%) participants in SWL and mini‐PCNL group were not included in the analysis, respectively.
Incomplete outcome data (attrition bias) Hospital stay	Low risk	5/111 (4.5%) and 4/110 (3.6%) participants in SWL and mini‐PCNL group were not included in the analysis, respectively.
Incomplete outcome data (attrition bias) Pain	Unclear risk	No information given.
Selective reporting (reporting bias)	Unclear risk	The outcomes were not prespecified and no published protocol available.
Other bias	Low risk	Not detected