Wang 2008.

Study characteristics
Methods	RCT. 3 arms.
Participants	Number of children: 100 control, 100 treatment Sex of children: 98 M, 102 F Age range of children: 8 ‐ 9 years Mean age of children: not reported Needle procedure: venepuncture Diagnosis: pneumonia, asthma, encephalitis, allergic purpura Inclusion criteria: 8 ‐ 9 years old, requiring venepuncture for a period of IV treatment in the pediatric department Exclusion criteria: history of puncture during the past 3 months, treatment with anxiolytic or narcotic analgesics medication 72 hours prior to the venepuncture, presence of insufficient mental development, alteration of mental status and cognitive impairment, visual and auditory deficits Setting: hospital pediatric department in China
Interventions	. Audiovisual distraction: Children watched cartoon videos during the procedure. They were given a choice of 10 appropriate cartoon videos. 2. Psychological interventions: Participants received conventional psychological interventions in a fixed scheme delivered by a research nurse (e.g. comfort provided, procedure explained, therapeutic touch, guided imagery, and encouragement) with no audiovisual distraction. 3. Control condition: Children received no intervention.
Outcomes	Pain measure: Child self‐report: 10 cm VAS 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:"randomly assigned…according to random numbers…generated for Research Randomizer" (p. 580 Par 6)
Allocation concealment (selection bias)	Unclear risk	Unclear if all appropriate safeguards taken with assignment envelopes (i.e. opaque)
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 self‐report 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 significantly different to length of procedure time (p.581)