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. 2018 Apr 18;2018(4):CD006545. doi: 10.1002/14651858.CD006545.pub3

Chan 2013.

Methods
  • Design: parallel, 2 arms

  • Country: Australia

  • Method of randomisation: method of minimisation

  • Blinding: children, caregivers, physicians, statistician

  • Location: Sydney Children's Hospital

  • Length of follow‐up: 24 weeks

Participants
  • Diagnosis: small, focal superficial IHs not requiring systemic therapy

  • Sex: female: 29; male: 12

  • Age: between 5 and 24 weeks

  • Inclusion criteria: infants between the ages of 5 and 24 weeks with small, focal superficial IHs not requiring systemic therapy

  • Exclusion criteria: hypersensitivity to timolol maleate, wheezing, cardiac rhythm disturbances or congenital heart disease, or large, ulcerated, mucosal, or subcutaneous IHs

  • Number of children randomised: 41 infants

Interventions
  • Intervention A (number of children: 19): timolol maleate 0.5% gel, 1 drop twice a day

  • Intervention B (number of children: 22): placebo gel, 1 drop twice a day

Outcomes Outcomes were not classified as primary or secondary:
  • Volume estimation at weeks 0 ,1, 2, 3, 4, 8, 12, 16, 20, and 24

  • Redness at weeks 0 ,1, 2, 3, 4, 8, 12, 16, 20, and 24

  • Safety data: heart rate, systolic blood pressure, diastolic blood pressure, measured before first dose and 1 hour after the initial dose, and then at every visit

Notes
  • Trial registration: ACTRN12610001069044

  • Funder: Sydney Children's Hospital Foundation, Vascular Birthmark Research fellowship position

  • Role of funder: funds for statistical analysis

  • A priori sample size estimation: no

  • Conducted: from March 2011 to April 2012

  • Declared conflicts of interest: yes (page e1739)

Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: “Patients were enrolled in the trial by 1 of 2 study physicians and randomly assigned (by using a method of minimization) by the clinical trials pharmacist into 4 groups: age between 5 and 15 weeks or between 16 and 24 weeks and size of lesion, < or > 25 mm”. Page e1740
Comment: Authors reported information about adequate random sequence generation.
Allocation concealment (selection bias) Low risk Quote: “Patients were enrolled in the trial by 1 of 2 study physicians and randomly assigned (by using a method of minimization) by the clinical trials pharmacist into 4 groups: age between 5 and 15 weeks or between 16 and 24 weeks and size of lesion, < or > 25 mm”. Page e1740
Comment: Authors reported information about adequate allocation concealment.
Blinding of participants (Performance bias) Low risk Quote: “Participants, caregivers, and physicians were blinded to group status”. Page e1740
Comment: Authors reported information about adequate blinding of participants.
Blinding of personnel (performance bias) Low risk Quote: “Participants, caregivers, and physicians were blinded to group status”. Page e1740
Comment: Authors reported information about adequate blinding of personnel.
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Quote: “Response to therapy was measured by (1) blinded predicted volume estimation at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20, and 24 and (2) blinded scoring of clinical photographs at 0, 12, and 24 weeks”. Page e1741
Comment: Authors reported information about adequate blinding of outcome assessment.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Data were analysed using intention‐to‐treat approach.
Selective reporting (reporting bias) Low risk All outcomes mentioned in the methods were reported on in the results.
Other bias Low risk No other biases were identified.