Goodenough 1997.

Study characteristics
Methods	RCT. 3 arms.
Participants	Number of children: 117 (39 in each group) Sex of children: 73 M, 44 F Age range of children: 3.5 ‐ 17.7 years Mean age range of children: not reported Needle procedure: venipuncture Diagnosis of child: none given (19.7% receiving investigation for chronic illness, 30.8% receiving routine investigation prior to hospital admission, 9.4% undergoing assessment of blood medication levels, 40% being treated for a variety of complaints) Inclusion criteria: 3 ‐ 17 years, consecutively scheduled to undergo venipuncture Exclusion: a major mental handicap Setting: Sydney Children’s Hospital, Australia
Interventions	1. Placebo cream plus suggestion: Children were given a placebo cream from a brightly‐wrapped container as the nurse said: “We are trying out a new special cream. I am going to put some cream on your arm that might make the needle hurt less.” 2. Placebo cream alone: Children were given a placebo cream from a plain white wrapped container as the nurse said: “I am going to put some cream on your arm.” 3. No cream control: No cream was applied and the nurse did not say anything beyond standard procedural instruction
Outcomes	Pain measures: Child self‐report: FPS post‐procedure Behavioral: Observer rating of child behavioral reaction to pain during procedure Distress measures: Child self‐report: Children’s Anxiety and Pain Scale (CAPS) Adverse events: none mentioned
Notes	We used a total N of 78 for this study (instead of 117) because we only included 2 of 3 interventions (placebo cream + Suggestion versus placebo cream alone). Study dates: study dates not reported Funding: Big Brother Movement, Brambles, Boots Co. (Australia), and private donations. Placebo cream was kindly supplied by the Pharmacy Department, Prince of Wales Hospital, Australia Conflicts of interest: none declared
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomized ‐ stratified by age ‐ no further details. Insufficient information to permit judgment of 'low' or 'high' risk
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgment of 'low' or 'high' risk
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Insufficient information to permit judgment of 'low' or 'high' risk
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Insufficient information to permit judgment of 'low' or 'high' risk
Incomplete outcome data (attrition bias) All outcomes	Low risk	Reasons for missing data unlikely to be related to true outcome
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgment of 'low' or 'high' risk
Other bias	Low risk	Appears to be free of other bias that would affect outcomes