Sahiner 2016.

Study characteristics
Methods	RCT. 4 arms.
Participants	Number of children: 30 control, 30 per treatment group (90) Sex of children: 63 M, 57 F Age range of children: 6 ‐ 12 years Mean age range of children: 9.1 ± 1.6 years Needle procedure: venipuncture Diagnosis of child: none reported Inclusion criteria: 6 ‐ 12 years, requested blood tests Exclusion criteria: none given Setting: Phlebotomy Unit of the Karaman Maternity and Children Hospital in Turkey
Interventions	1. Distraction cards: Children received visual cards covered with pictures and shapes just before the procedure. The child carefully examined the cards and then the researcher asked questions about the cards (e.g. Can you see the comet?) until the procedure was complete. 2.Listening to cartoon music: Music from 15 cartoons watched by children aged 6 to 12 years was played and the child was asked to identify which cartoon the music belonged to. A new song was played when the child recognized the music until the procedure was complete. 3. Balloon Inflation: Children were given a balloon of their color choice. They were asked to inflate the balloon before the procedure and keep on inflating until the procedure was complete. Children were given the balloons to keep. 4. Control: The routine blood‐taking procedure was followed.
Outcomes	Pain measure: Child self‐report: Wong Baker FACES scale Parent report of child pain: Wong Baker FACES scale Researcher report of child pain: Wong Baker FACES scale Distress measure: Parent report of child anxiety: CFS Researcher report of child anxiety: CFS 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)	Low risk	Quote: "computer generated table of random numbers" (p. 4)
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)	Low risk	Objectives clearly stated and fully reported
Other bias	Low risk	Appears to be free of other bias that would affect outcomes