Press 2003.

Study characteristics
Methods	RCT. 2 arms.
Participants	Number of children: 46 control, 48 treatment Sex of children: 57 M, 37 F Age range of children: 6 ‐ 16 years Mean age of children: 11.5 ± 2.5 years (intervention); 9.9 ± 2.3 years (control) Needle procedure: venepuncture Diagnosis: none reported Inclusion criteria: 6 ‐ 16 years old, undergoing venepuncture, conscious, Hebrew –speaking, no hearing problems Exclusion criteria: none reported Setting: pediatric emergency department of the Saroka University Medical Centre, Israel
Interventions	1. Active distraction: Children listened to music using headphones and were asked a question about the song’s content. 2. Standard care control: Nurses provided usual care.
Outcomes	Pain measures: Child self‐report: 10 cm VAS combined with a Faces Pain Scale Parent report: 10 cm VAS combined with a Faces Pain Scale Nurse report: 10 cm VAS combined with a Faces Pain Scale Adverse events: none mentioned
Notes	Study dates: study dates not reported Funding: none stated Conflicts of interest: none declared
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomized ‐ 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	High risk	Study participants and personnel were not blinded
Blinding of outcome assessment (detection bias) All outcomes	High risk	No blinding of outcome assessment
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing data
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgment of 'low' or 'high' risk
Other bias	High risk	Had a potential source of bias related to the specific study design (e.g. modified pain measure)