Rudofsky 1986.

Methods	Study design: 2 parallel arms, randomised, double‐blind. Method of randomisation: random number generator. Exclusion post randomisation: none. Losses to follow up: 1. Quality score = 5.
Participants	Country: Germany. Setting: hospital. No: 40 entered, 1 drop out. Age: (mean) 41 and 38 years in treatment and placebo groups, respectively. Sex: males 14, females 25. Inclusion criteria: clinical signs of CVI (e.g. varicosis, hyperpigmentation), symptoms (e.g. leg pain, pruritus), venous capacity of over 6 ml per 100 ml tissue, venous pressure (dorsum pedis) of at least 60 mmHg. Exclusion criteria: CVI stage III, acute phlebitis, oedema of other origin than CVI, concomitant medication (e.g. diuretics, vasoactive drugs).
Interventions	Treatment: 1 capsule HCSE (standardised to 50 mg escin) twice daily. Control: placebo. Duration: 4 weeks.
Outcomes	Primary: (not explicitly stated) leg volume (ml) Secondary: (not explicitly stated) 1) circumference 2) leg pain 3) pruritus
Notes	Standardised mean difference (95% CI): Primary: 0.46 (‐0.18 to 1.10) Secondary: Not enough data provided for effect size calculation.
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment (selection bias)	Unclear risk	Allocation concealment not reported
Blinding (performance bias and detection bias) All outcomes	Low risk	Verum and placebo capsules were indistinguishable .... Thus it was impossible for physician and patient to determine whether they received the true or placebo medication
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	It is unclear how incomplete outcome data were addressed
Selective reporting (reporting bias)	Low risk	No evidence of selective reporting
Other bias	Unclear risk	There is no evidence of other biases