Picarelli 2010

Methods	Parallel RCT
Participants	Country of study: Brazil Setting: laboratory Condition: CRPS type I Prior management details: refractory to best medical treatment n = 23 Age mean (SD): active group 43.5 (12.1) years, sham group 40.6 (9.9) years Duration of symptoms (months mean (SD)): active group 82.33 (34.5), sham group 79.27 (32.1) Gender distribution: 14 F, 9 M
Interventions	Stimulation type: rTMS Stimulation parameters: frequency 10 Hz; coil orientation posteroanterior, number of trains 25; duration of trains 10 s; ITI 60 s, intensity 100% RMT, total number of pulses 2500 Stimulation location: M1 contralateral to painful limb Number of treatments: 10, x 1 daily on consecutive weekdays Control type: sham coil ‐ did not control for sensory cues
Outcomes	Primary: pain VAS; 0 = "no pain", 10 = "most severe pain" When taken: after first and last session then 1 and 3 months post‐treatment Secondary: QoL SF‐36, not reported
Notes	COI: study authors declared no COI Sources of support: University of Sao Paolo, Brazil
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: while stated "randomized" the method of randomisation not reported
Allocation concealment (selection bias)	Unclear risk	Allocation concealment not reported
Adequate blinding of participants?	Unclear risk	Comment: sham suboptimal as it did not control for scalp sensation. Study reported that number who guessed the condition correctly was similar but no formal data or analysis reported
Adequate blinding of assessors?	Unclear risk	Comment: study described as "double‐blinded" but assessor blinding not specifically reported
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: only 1 participant dropped out at follow‐up
Selective reporting (reporting bias)	Low risk	Comment: data presented for primary outcome. While this was not adequate for meta‐analysis it did not really constitute selectivity. No response received to request for full data access
Study Size	High risk	Comment: < 50 participants per treatment arm
Study duration	Low risk	Comment: ≥ 8 weeks' follow‐up
Other bias	Low risk	Comment: no other biases detected