Mullan 2009.

Methods	Study design: clinician‐randomized trial Unit of allocation: clinicians Unit of analysis: patient Power calculation: done
Participants	Setting of care: primary care, ambulatory care, USA Healthcare professionals: 40; various healthcare professional and inter‐professional (physicians, physicians assistant, nurse practitioners managing diabetes); Fully trained and residents Patients: 85; diabetes type 2; males and females
Interventions	Multifaceted intervention: patient‐mediated intervention (decision aid used during the clinical encounter); and educational training (how to use decision aid) Quote: "[The Diabetes Medication choice decision aid tool]  is designed to enable clinicians to discuss with patients the potential advantages and disadvantages of adding an [antihyperglycemics pharmaceutical] agent." page 1562 « Ideally, the clinician presents all 6 cards [describing the possible side effect of the medication] to the patient and asks which of the cards the patient would like to discuss first. After reviewing and discussing the cards that the patient and the clinician choose [what] to discuss." page 1562 Quote; "The patient receives a copy of the cards in the form of a take‐home pamphlet." page 1562 "Clinicians randomised to the intervention arm received a brief demonstration from the study coordinator on how to use the decision aid prior to meeting the first enrolled patient." page 1562 Single intervention (control): patient‐mediated intervention (decision aid). Quote: "... 12‐page general pamphlet on oral antihyperglycemics medication to take home." page 1562
Outcomes	OPTION (continuous, score) and validated pictorial instrument ; SDM is assessed as the fostering by healthcare professionals of active participation of patients in the decision‐making process.
Notes	Additional information Number of approached patients (eligible): 1341 Number of patients per physician: at least one, page 1563
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "A computer‐generated allocation sequence, unavailable to personnel enrolling patients or clinicians, randomized clinicians to intervention (decision aid) or usual care and was accessed by the study coordinators via telephone." page 1562
Allocation concealment (selection bias)	Low risk	Quote: "A computer‐generated allocation sequence, unavailable to personnel enrolling patients or clinicians, randomized clinicians to intervention (decision aid) or usual care and was accessed by the study coordinators via telephone." page 1562
Blinding (performance bias and detection bias) Observer‐based outcome	Unclear risk	Comment: not specified in the paper.
Blinding (performance bias and detection bias) Participant‐reported outcome	Unclear risk	Comment: not specified in the paper.
Incomplete outcome data (attrition bias) Observer‐based outcome	Low risk	Comment: 18 vs 16 visits were recorded. In both groups reasons were either because patient/clinician did not wish to be recorded or technical difficulties.
Incomplete outcome data (attrition bias) Participant‐reported outcome	Low risk	Comment: lost to follow‐up patients were balanced in number and reasons across groups (fig 2).
Selective reporting (reporting bias)	High risk	Comment: the PROM was not reported (validated pictorial instrument).
Other bias	Low risk	Comment: no evidence of other risk of biases.
Baseline measurement? Observer‐based outcome	Unclear risk	Comment: not specified in the paper.
Baseline measurement? Participant‐reported outcome	Unclear risk	Comment: not specified in the paper.
Protection against contamination?	Unclear risk	Comment: unit of allocation is the clinician and not separated by primary care and family medicine sites.
Baseline characteristics patients	Low risk	Comment: see table 1.
Baseline characteristics healthcare professionals	Unclear risk	Comment: insufficient data about provider in table 1. There are more physicians and nurses in the DA group.