Hearnden 2009.

Methods	Study design: single‐centre, parallel‐group, two‐arm, single‐blind randomised placebo‐controlled trial Setting: orthopaedics referrals from general practice, Wrightington Hospital, UK Trial time period: not reported Interventions: ESWT vs placebo Sample size calculation: not performed Analysis: ITT
Participants	Number of participants: screened: 27 (7 did not meet inclusion criteria) randomised: 20 (11 in ESWT group; 9 in placebo group) included in analyses: 20 (11 in ESWT group; 9 in placebo group) Inclusion criteria: Gärtner type I or II calcific deposit on X‐ray shoulder pain secondary to supraspinatus tendonitis (diagnosed using MRI in 8 participants or US scan in 15 participants) pain for > 12 months failure of conservative therapy Exclusion criteria: rotator cuff rupture local arthritic changes or generalised polyarthropathies neurogenic syndromes pregnancy infection coagulation disorders Baseline characteristics: numerical data were not reported Pretreatment group differences: authors reported that participants in both groups were well matched in demographics, symptoms and calcific deposits (no numerical data reported)
Interventions	ESWT: description of modality: not reported method of administration: location of the calcific deposit was marked on the skin using high‐resolution US by the radiographer. The area was the infiltrated with 20 mL 0.5% marcaine. The lithotripter was then placed on the shoulder and using the in‐line US imaging the ESWT was focused on the deposit, applying the appropriate dose. dose: 2000 shocks fixed at 0.28 mJ/mm² frequency: 1 dose co‐interventions: none Placebo description of modality: not reported method of administration: as above dose: 20 shocks with a negligible EFD of 0.03 mJ/mm² frequency: 1 dose co‐interventions: none
Outcomes	Measured at 6 months Outcomes included in review: mean change in function measured by CMS, 0–100 with a higher score indicating better function calcification size measured by X‐ray and US mean pain associated with treatment measured on VAS 0–10 cm, higher score indicating more pain treatment success: participant‐reported global assessment of satisfaction as a dichotomous outcome adverse events withdrawals due to adverse events, intolerance to treatment or other reasons  Outcomes excluded from review: time to return to work participant‐reported success of outcome measured on a categorical scale (worse, no change, some improvement, complete resolution)
Source of funding	Not reported
Notes	Trial registration: not reported Time points included in review: 6 months Data analysis: function was extracted at 6 months, treatment success was extracted at the study's conclusion (6 months). Pain, calcification size and adverse events could not be extracted as the data were only reported for the intervention group. As no SDs were reported for function and there were none available in study, the SD at 6 months for active and sham groups were taken from Gerdesmeyer 2003. Withdrawals: none Adverse events: ESWT: serious adverse events: 0/11 other adverse events: 9/11 (9/11 had pain following shock wave after the effect of the anaesthetic wore off. 7/11 had bruising following shock waves which resolved quickly) Placebo: serious adverse events: 0/9 other adverse events: 0/9
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation 'using a centralised list in blocks to get two equal groups'.
Allocation concealment (selection bias)	Low risk	Treatment allocations were kept in sealed opaque envelopes.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Participants blinded to treatment allocation, not reported if outcome assessors were blinded.
Blinding of outcome assessment (detection bias) Self‐reported outcomes	Low risk	Participants unaware of treatment received, thus the risk of bias was low for self‐reported outcomes (pain, function and treatment success).
Blinding of outcome assessment (detection bias) Assessor‐reported outcomes	Unclear risk	Not reported if the radiographer measuring calcification was blinded to the group allocations.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No withdrawals.
Selective reporting (reporting bias)	High risk	There was no published study protocol. The summary data for both groups were not reported. VAS pain scores and calcification changes in placebo group were not reported.
Other bias	Low risk	No other biases apparent.