Goldberg 2001.

Methods	Cluster RCT Follow up: providers: NOT CLEAR patients: DONE Blinded assessment: DONE Baseline: DONE Reliable outcomes: DONE Protection against contamination: DONE Overall quality: MODERATE
Participants	Spine surgeons, primary care physicians, patients who were surgical candidates, and hospital administrators in ten communities with annual rates of back surgery above the 1990 national average Country: USA Proportion of eligible providers who participated: 12% Setting of care: hospital setting Academic/Teaching setting: NOT CLEAR Type of targeted behaviour: Surgery (rate of back surgery) Complexity of targeted behaviour: HIGH
Interventions	1. CME: regional study group meetings for neurosurgeons and orthopedists + CME conferences for primary care providers + mailed generalist academic detailing + videodisc patient decision making + small discussion groups of key administrative personnel 2. No intervention control
Outcomes	Professional practice: low‐back surgical rate Patient: none Seriousness of outcome: HIGH
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear