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. 2010 Jan 20;2010(1):CD003974. doi: 10.1002/14651858.CD003974.pub3

Hossmann 1981.

Methods Design: four period, four group, cross‐over trial 
 Purpose: examine the effect of hospitalisation (habituation to the medical environment and rest in hospital bed) and placebo on arterial hypertension
Participants Patients: patients with untreated essential hypertension
Interventions Placebo: oval pink tablet 
 Untreated: no tablet 
 Experimental: hospitalisation 
 (Co‐intervention: NS)
Outcomes Diastolic arterial blood pressure (mm Hg) 
 Systolic arterial blood pressure (mm Hg) 
 Heart rate 
 Plasma renin activity 
 Plasma norepinephrine activity 
 Anxiety scores 
 Urinary catecholamines
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Adequate sequence generation? Unclear risk NS
Allocation concealment? Unclear risk NS
Blinding? 
 Treatment provider Unclear risk NS
Blinding? 
 Outcome assessor Unclear risk NS
Incomplete outcome data addressed? 
 All outcomes High risk Drop‐out > 15% or NS
Free of selective reporting? Unclear risk No protocol available
Free of other bias? Low risk  
No signs of variance inequality or skewness? Low risk No variance inequality (F‐test not statistically significant) and no skewness (1.64 standard deviations does not exceed the mean)
Trial size > 49? High risk N = 24
Clearly concealed allocation + trial size > 49 + drop‐out max 15% High risk Trial size < 49