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

Rupert 1978.

Methods Design: factorial design, 3 (biofeedback, placebo, no biofeedback) x 2 (instructions to increase or decrease heart rate) + 1 (no treatment) 
 Purpose: examine the effect of biofeedback on anxiety and heart rate
Participants Patients: psychiatric in‐patients deemed to have a high degree of anxiety problems by their physician 
 Baseline comparability: yes (anxiety scores, heart rate)
Interventions Placebo: biofeedback sessions with false positive feedback 
 Untreated: no sessions (observational) 
 Experimental: biofeedback sessions with correct feedback 
 (Co‐intervention: anxiolytics, fixed dosage.)
Outcomes Anxiety 
 Heart rate
Notes Relevant outcome data not accessible
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? High risk Relevant outcome data not accessible
Free of other bias? Low risk  
Trial size > 49? High risk N = 16
Clearly concealed allocation + trial size > 49 + drop‐out max 15% High risk Trial size < 49