Potential bias | Authors' judgement |
Random sequence generation (selection bias) |
High – not randomized or quasi‐randomized Unclear – states "randomized", but does not report method Low – describes method of randomizations |
Allocation concealment (selection bias) |
High – not concealed, open‐label trial for individually randomised, method of concealment not adequate Unclear – details of method not reported or insufficient details Low – central allocation, sequentially numbered opaque sealed envelopes |
Blinding (performance bias and detection bias) |
High – personnel, participants or outcome assessors not blinded Unclear – no details reported, insufficient details reported Low – personnel, participants and outcome assessors blinded |
Incomplete outcome data (attrition bias) |
High – losses to follow‐up not evenly distributed across intervention and control group, high attrition rate (20% or more for the main outcome) Unclear ‐ no details reported, insufficient details reported Low – no losses to follow‐up, losses below 20% and evenly distributed across groups, ITT analysis used. Note: for cluster‐RCTs, the loss relates to the clusters |
Selective reporting (reporting bias) |
High – did not fully report measured or relevant outcomes Unclear – not enough information reported to judge Low – all stated outcomes reported |
Other bias |
Low – no obvious other source of bias of concern to reviewers High – major source of bias such as unexplained differences in baseline characteristics |