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. 2019 Dec 18;2019(12):CD011016. doi: 10.1002/14651858.CD011016.pub2

Pinheiro 2007.

Methods Study design: randomized, parallel‐group, controlled trial
Study site(s): single‐center
Number randomized (total and per group): 38 participants in total; 13 participants in the flaxseed 1 g group; 12 participants in the flaxseed 2 g group; 13 participants in the placebo group
Unit of randomization (individual or eye): individual
Exclusions after randomization: not reported
Losses to follow‐up: not reported
Unit of analysis (individual or eye): individual (average of both eyes)
Reported power calculation? (Y/N): N
Reported subgroup analysis? (Y/N): N
Participants Participant characteristics
Country: Brazil
Age (mean ± SD, range): range 21 to 55 years
Gender: 38 women
Inclusion criteria:
1. TBUT ≤ 8 seconds
2. Schirmer test type ≤ 8 mm/5 min
3. van Bjisterveld with a score of 3 to 7
Exclusion criteria: not reported
Equivalence of baseline characteristics? (Y/N): Y
Interventions Intervention #1: oral flaxseed oil capsule 1 g, 1 capsule (Douglas Laboratories, Pittsburgh, PA, USA, imported by "Langfor Import and Distribution" São Paulo, SP, Brazil) plus a placebo capsule (950 mg synthetic mineral oil, 50 mg of evening primrose oil)
Intervention #2: oral flaxseed oil capsule 1 g, 2 capsules (2 g in total)
Intervention #3 (control): placebo capsule (950 mg synthetic mineral oil, 50 mg evening primrose oil), 2 capsules (2 g)
Length of follow‐up: 180 days
Notes: none
Outcomes Primary and secondary outcome measures not clearly distinguished
Specified outcome(s): OSDI; conjunctival impression cytology; TBUT; Schirmer test with anesthesia
Adverse events reported? (Y/N): N
Measurement time points (specify intervals at which outcomes were assessed): baseline, day 180
Other issues with outcome assessment (eg, quality control for outcomes, if any): none
Notes Study dates: not reported
Funding source(s): not reported
Conflicts of interest: not reported
Publication language: Portuguese
Registered on clinical trials registry? (Y/N): N
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Method of random sequence generation was not reported
Allocation concealment (selection bias) Unclear risk Allocation concealment was not reported
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk "Double‐blind" study; placebo capsule had identical appearance to treatment capsule; details of masking of personnel were not reported
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk "Double‐blind" study, but details of masking of outcome assessors were not reported
Incomplete outcome data (attrition bias) 
 All outcomes Unclear risk Numbers of participants who were excluded, lost to follow‐up, and included in the final analysis were not reported
Selective reporting (reporting bias) Unclear risk No access to study protocol or clinical trials registry
Other bias Unclear risk Funding source(s) and conflicts of interest were not reported