Khedr 2005

Methods	Parallel RCT
Participants	Country of study: Egypt Setting: university hospital neurology department Condition: neuropathic pain, mixed central (poststroke) and facial (trigeminal neuralgia) pain Prior management details: refractory to drug management n = 48 Age: poststroke 52.3 (SD 10.3) years, trigeminal neuralgia 51.5 (SD 10.7) years Duration of symptoms: poststroke 39 months (SD 31), trigeminal neuralgia 18 months (SD 17) Gender distribution: 8 M, 16 F
Interventions	Stimulation type: rTMS Stimulation parameters: frequency 20 Hz; coil orientation not specified; 80% RMT; number of trains 10; duration of trains 10 s; ITI 50 s; total number of pulses 2000 Stimulation location: M1 contralateral to the side of worst pain Number of treatments: 5, x 1 on consecutive days Control type: coil elevated and angled away from scalp
Outcomes	Primary: pain VAS, anchors not specified When taken: post 1st, 4th and 5th stimulation session and 15 days after the last session Secondary: none
Notes	AEs: not reported COI: study authors declared no COI Sources of support: no declaration made
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Quote: "Patients were randomly assigned to one of the two groups, depending on the day of the week on which they were recruited." Comment: not truly random
Allocation concealment (selection bias)	High risk	Comment: the method of sequence generation makes concealment of allocation unlikely
Adequate blinding of participants?	Unclear risk	Comments: sham credibility assessment ‐ suboptimal. Coil angled away from scalp and not in contact in sham condition. Did not control for sensory characteristics of active stimulation and was visually distinguishable
Adequate blinding of assessors?	Low risk	Quote: "The second author evaluated these measures blindly—that is, without knowing the type of rTMS"
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: no dropout apparent from the data presented
Selective reporting (reporting bias)	Low risk	Comment: while pain score numerical values were not provided clearly with measures of variance for all time points in the study report, the study authors have provided the requested data
Study Size	High risk	Comment: < 50 participants per treatment arm
Study duration	Unclear risk	Comment: ≥ 2 weeks but < 8 weeks' follow‐up
Other bias	Low risk	Comment: no significant other bias detected