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

Markland 1993.

Methods Design: three group parallel trial 
 Purpose: examine the effect of a relaxation tape session on preoperative anxiety
Participants Patients: in‐patients undergoing day‐case surgery 
 Baseline comparability: yes, except for diastolic blood pressure
Interventions Placebo: session where patients listen to a recorded short story 
 Untreated: no session 
 Experimental: session where patients listen to a recorded relaxation procedure 
 (Co‐intervention: NS)
Outcomes Anxiety (Spielberger state trait anxiety inventory) 
 Heart rate 
 Blood pressure 
 Anaesthesia measures (dose of sedative, time to settle the patient, mean concentration per min of isoflurane, anaesthetist's score)
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Adequate sequence generation? Unclear risk NS
Allocation concealment? Unclear risk NS
Blinding? 
 Treatment provider High risk Not described as double‐blind (placebo/relaxation procedure)
Blinding? 
 Outcome assessor Unclear risk Not relevant as patient reported outcome
Incomplete outcome data addressed? 
 All outcomes Low risk Drop‐out < 15%
Free of selective reporting? Unclear risk No protocol available
Free of other bias? Low risk  
No signs of variance inequality or skewness? Unclear risk Not relevant (not naturally positive continuous outcomes e.g. change)
Trial size > 49? High risk N = 14
Clearly concealed allocation + trial size > 49 + drop‐out max 15% High risk Trial size < 49