Meng 1999

Methods	Randomised trial comparing the use of postoperative branched chain amino acid supplement to no supplement in patients who underwent surgery for an attempted curative resection for hepatocellular carcinoma. Geographical location: Hong Kong. Paper published 1999.
Participants	Inclusion criteria: Patients with cirrhosis undergoing attempted curative resection of hepatocellular carcinoma. Exclusion criteria: Palliative resection, benign nodular hyperplasia, adenoma. 44 patients (37 male/7 female [4 other dropouts], median age 52).
Interventions	Intervention group received branched chain amino acid supplement (Aminoleban EN®) ‐ 3 packs/day (? 50 gm packs); Control group received isocaloric, isonitrogenous diet. Duration of therapy 12 weeks.
Outcomes	Mortality, appearance gastrointestinal bleeding/hepatic encephalopathy, infections, duration hospitalization postoperative total complications (total number, not number of patients with complications)/intra‐abdominal complications/wound infections/pneumonia/major complications (not predefined outcome). Paper indicates that serum bilirubin better in treatment group, but no usable numerical data. Paper indicated that there were no differences in body weight, triceps skinfold thickness, midarm circumference, but no numerical data.
Category of study	Supplements/Surgery.
Sample size calculation	Not reported if done.
Full paper or abstract only	Full paper.
Notes	Request for further information sent to Drs Meng and Lau via e‐mail (mengcs@ha.org.hk and josephlau@cuhk.edu.hk) on September 19, 2011. No response has been received as of March 20, 2012.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated sequence.
Allocation concealment (selection bias)	Unclear risk	Closed envelopes, but not stated if opaque, serially numbered.
Blinding (performance bias and detection bias) All outcomes	High risk	Not blinded.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Four dropouts from treatment group, 2 dropouts from control group accounted for.
Selective reporting (reporting bias)	Low risk	Mortality and morbidity outcomes reported.
Other bias	High risk	Funded by industry.
Intent to treat analysis	High risk	Could not be done.
Baseline imbalance?	Low risk	No differences in per protocol groups.
Early stopping?	Unclear risk	No sample size calculation and unknown why stopped.