Karst 2007.

Methods	Design: four group parallel trial Purpose: study the effect of auricular acupuncture on dental procedural anxiety
Participants	Patients: outpatients undergoing dental extraction Baseline comparability: yes
Interventions	Placebo: needling with non penetrative needle at points not regarded having effect on anxiety (finger and liver points) Untreated: no needling Experimental: ‐needling at ' ... relaxation, tranquillizer, and master cerebral points in the external ear ...'. ‐midazolam, intranasal (average dose 4mg) (Co‐intervention: NS)
Outcomes	Spielberger state‐trait anxiety inventory VAS Sedation score Quality of dental condition Physiological status
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Low risk	'list of random numbers'
Allocation concealment?	Unclear risk	NS
Blinding? Treatment provider	High risk	Not described as double‐blind (placebo/acupuncture)
Blinding? Outcome assessor	Unclear risk	Not relevant as patient reported outcome
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 = 29
Clearly concealed allocation + trial size > 49 + drop‐out max 15%	High risk	Trial size < 49