McGregor 2004.

Methods	Randomised parallel group trial.
Participants	35 participants (25 women, 10 men; mean age 72 years, SD 9, range 51 to 92) undergoing total hip replacement. Intervention group: 19 participants (mean age 71 years, SD 9); control group: 20 participants (mean age 73 years, SD 10). Inclusion criteria: none stated. Exclusion criteria: revision or bilateral arthroplasty, previous hip joint surgery, co‐existing morbidity, mental confusion, inadequate comprehension of English. Location: London, UK.
Interventions	Intervention group (n = 19) attended a preoperative hip class 2‐4 weeks before surgery and received an information booklet containing information about the surgery, pre‐ and postoperative stages and rehabilitation, including exercises. The preoperative class reinforced the information in the booklet and covered adaptations participants could make to their homes in the immediate postoperative period. Control group (n = 20) received the standard preoperative management that included a description of the surgery and its risk. They did not receive an information booklet or attend a class.
Outcomes	Function (WOMAC, administered using the Likert Scale version, which ranges from 0 to 68 where a higher score represented more dysfunction*; Harris Hip Score (maximum 100 points) 90‐100: good function and excellent results, 80‐90: good, 70‐80: fair, < 70: poor results; and Barthel Activities of Daily Living Index (0‐20 points) higher score represented less dysfunction); pain (WOMAC Likert Scale version (0‐20 points) higher score represented worse pain; and a VAS (0‐10 points) higher score indicated worse pain**) and expectations of postoperative pain (VAS, units of measurement not reported); mood (Positive Affect Negative Affect Scale); fatigue (VAS, units of measurement not reported); satisfaction (VAS, units of measurement not reported); length of hospital stay; economic analysis (EuroQoL EQ‐5D); complications. Participants were assessed preoperatively, at discharge, and 3 months postoperatively.
Notes	*WOMAC function scale data at 3 months included in Analysis 1.2. **Only the 0‐10 VAS was included in the analysis of 'pain'. Trialists only reported that "On average, patients in group A spent 15 days in the hospital for the surgical procedure, whereas patients in group B spent 18 days in the hospital". Requests for the SDs of each group were unsuccessful.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "...patients were allocated randomly into either group A or group B." Comment: sequence generation not described.
Allocation concealment (selection bias)	Unclear risk	Quote: "...patients were randomized by age and not functional status." Comment: how participants were stratified and whether allocation was concealed was not described.
Blinding (performance bias and detection bias) Self‐reported outcomes	High risk	Comment: no description of any attempt to blind participants and blinding is unlikely to have been possible. Knowledge of being in the intervention group may have influenced participants' preoperative expectations of postoperative pain, mood and pain.
Blinding (performance bias and detection bias) Objective outcomes	Unclear risk	Comment: not stated.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote: "...4 patients [from the intervention group] were subsequently lost to review." Comment: reasons for loss to follow‐up not stated. Impact of incomplete data likely to be minimal because outcomes were all continuous measures. Not clear if the pre‐discharge results included the 4 participants subsequently lost to review.
Selective reporting (reporting bias)	High risk	Comment: SDs for length of hospital stay were missing from the published report. All other outcomes listed in the methods were reported in the results, but without the trial protocol, it is unclear whether any other outcomes were measured but not reported based on the results.
Other bias	Low risk	Comment: no other sources of bias identified.