Haake 2002.

Methods	Study design: parallel‐group, two‐arm, single‐blind, RCT Setting: Germany Trial time period: participant enrolment from September 1998 to December 1999 Interventions: ESWT focused on the origin of supraspinatus tendon vs ESWT focused on the calcific deposit Sample size calculation: sample size calculation not performed Analysis: ITT
Participants	Number of participants: screened: not reported enrolled: 50 randomised: 50 (25 in ESWT to calcific deposit group and 24 in ESWT to supraspinatus tendon (tuberculum majus) group); 1 participant in ESWT to supraspinatus tendon group never returned after the initial visit included in analyses at 12 weeks: 47 (24 in ESWT to calcific deposit group and 23 in ESWT to supraspinatus tendon group) included in analyses at 12 months: 49 (25 in ESWT to calcific deposit group and 24 in ESWT to supraspinatus tendon group) Inclusion criteria symptomatic calcifying shoulder tendinopathy symptoms for ≥ 6 months Gärtner Stage I or II deposit ≥ 0.5 cm diameter free ROM or ≥ 90 degrees abduction and free rotation failed conservative treatment including a minimum of: 10 sessions of physiotherapy plus 2 subacromial injections plus 6 sessions of physical therapy plus intake of NSAIDs no treatment in past 4 weeks Exclusion criteria glenohumeral or acromioclavicular joint arthrosis previous operations to the treated shoulder acute bursitis of the shoulder instability of the shoulder local tumours or infections neurological disorders rotator cuff lesion allergy to mepivacaine aged < 18 years pregnancy Baseline characteristics: ESWT to supraspinatus tendon (25 participants): mean (SD) pain during rest NRS 0–11 scale: 7.17 (2.53) mean (SD) pain during activity, NRS 0–11 scale: 8.54 (1.91) mean (SD) function Constant 0–100 score: 47.17 (11.53) calcification size: not reported ESWT to calcific deposit (25 participants): mean (SD) pain during rest, NRS 0–11 scale: 7.08 (2.74) mean (SD) pain during activity, NRS 0–11 scale: 8.56 (1.58) mean (SD) function Constant 0–100 score: 49.96 (10.87) calcification size: not reported Pretreatment group differences: none
Interventions	ESWT to supraspinatus tendon description of modality: adapted shock wave generator Storz Minilith SL‐1 (Storz Medical AG, CH 8280 Kreuzlingen, Switzerland method of administration: subacromial local anaesthesia was given using 15 mL mepivacaine 1%. dose: 2000 impulses of a positive EFD of 0.35 mJ/mm² measured with a membrane hydrophone at 120 impulses per minute were applied using fluoroscopic localisation at the origin of the supraspinatus tendon frequency: 2 sessions at 1 week apart ESWT to calcific deposit description of modality: as above method of administration: as described above with 1 difference, shock waves were aimed specifically at the calcific deposit dose: as above frequency: as above
Outcomes	Measured at 12 weeks and 1 year Outcomes included in review: function measured by CMS 0–100 with a higher score indicate better function pain at rest measured on visual NRS 0–11, 11 indicating maximum pain complete resorption of calcific deposit participant satisfaction with treatment adverse events withdrawals: due to adverse events, intolerance to treatment or other reasons Outcomes excluded from review: pain during activity measured on VAS 0–11, 11 indicating maximum pain treatment success rate: success defined as 80% of the normal value in age‐corrected CMS
Source of funding	Not reported
Notes	Trial registration: not reported Time points included in review: 12 weeks and 12 months Data analysis: function and pain at rest extracted at 12 weeks and 1 year; resorption of calcific deposit extracted at 1 year; participant satisfaction extracted at end of study period. Participant satisfaction was extracted as the measure to represent treatment success, over the number achieving 80% of the normal value for the age‐standardised Constant score Withdrawals: 1/25 in ESWT to supraspinatus tendon group (withdrew consent after randomisation); 0/25 in ESWT to calcific deposit group Adverse events: ESWT to supraspinatus tendon: serious adverse events: 0/25 other adverse events: 0/25 ESWT to calcific deposit: serious adverse events: 0/25 other adverse events: 0/25
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated randomisation in permutated blocks.
Allocation concealment (selection bias)	Unclear risk	Methods not reported.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Participants and outcome assessors blinded to treatment assignments.
Blinding of outcome assessment (detection bias) Self‐reported outcomes	Low risk	Participants blinded to treatment allocation, thus there was a low risk of detection bias in reporting of self‐reported outcomes (including pain, function and patient satisfaction).
Blinding of outcome assessment (detection bias) Assessor‐reported outcomes	Low risk	Blinded independent observers assessed other outcomes, such as radiographic assessment.
Incomplete outcome data (attrition bias) All outcomes	Low risk	1/25 in ESWT to supraspinatus tendon group (withdrew consent after randomisation) and 0/25 in ESWT to calcific deposit group.
Selective reporting (reporting bias)	Low risk	No published study protocol, but results reported for all outcomes as mentioned in methods, and included major outcomes.
Other bias	Low risk	No other biases apparent.