Trinder 2006.

Methods	Randomised controlled trial comparing medical and expectant management with surgical management of first trimester miscarriage. This was a multi‐centre trial with 7 participating hospitals, each of which had an early pregnancy clinic. Recruitment started in May 1997 and finished in December 2001.
Participants	Women with a pregnancy of less than 13 weeks’ gestation who had been diagnosed as having either an incomplete miscarriage or early fetal/embryonic demise were eligible.
Interventions	Intervention: in the medical management arm, women with an incomplete miscarriage were admitted to hospital and given a single vaginal dose of 800 mcg misoprostol.1200 women with early fetal or embryonic demise were pre‐treated with a single oral dose of 200 mg mifepristone,21 then admitted to hospital 24‐48 hours later for a single vaginal dose of 800 mcg misoprostol (n = 398). Control: women in the expectant management arm were allowed home with no intervention (n = 399). Control: women in the surgical management arm were admitted for surgical suction curettage under general anaesthesia (n = 403).
Outcomes	Confirmed gynaecological infection at 14 days and 8 weeks; need for unplanned admission or surgical intervention.
Funding	The MIST study was funded by a South and West NHS Executive research and development grant. A donation of £20 000 was accepted from Exelgyn. Neither the NHS Executive nor Exelgyn had any role in the study design; collection, analysis, or interpretation of data; writing of the report; or the decision to submit the paper for publication.
Declarations of interest	The study group accepted a donation of £20 000 from Exelgyn, the manufacturers of mifepristone. The authors have no other competing interests.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Randomisation was by a central telephone system at the Clinical Trials Services Unit, Oxford. We used minimisation to ensure comparability between women with respect to participating centre, parity, type of miscarriage, and gestation". Comment: this still does not state how the randomisation scheme was generated.
Allocation concealment (selection bias)	Low risk	Comment: use of a central telephone system for randomisation, operated by other persons than the doctors randomising the patients.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: according to the flowchart loss to follow‐up was < 10%.
Selective reporting (reporting bias)	Low risk	Comment: flow chart displays all eligible and recruited women. No signs of selective reporting; all outcomes mentioned in the methods section were presented in the results section.
Other bias	Low risk	No other source of bias could be detected
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: there is no information on blinding of patients and personnel. However, due to the nature of the interventions, blinding would be practically impossible.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Comment: no information on blinding of outcome assessment, probably not done.