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

Tuomilehto 1980.

Methods Design: three group parallel trial 
 Purpose: examine the effect of high fibre intervention (guar gum) on serum lipoproteins and body weight
Participants Patients: out‐patients with hypercholesterolaemia 
 Baseline comparability: NS
Interventions Placebo: granule with no guar gum (wheat flower) 
 Untreated: no granule 
 Experimental: granule with guar gum 
 (Co‐intervention: diet instructions: decrease alcohol and fat, increase complex carbohydrates)
Outcomes Serum‐cholesterol: total (mmol/l) 
 Serum‐cholesterol: high density lipoprotein 
 Serum‐triglyceride 
 Weight 
 Blood pressure
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Blinding? 
 Treatment provider Low risk '... studied in a double‐blind controlled trial'
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? 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 = 22
Clearly concealed allocation + trial size > 49 + drop‐out max 15% High risk Trial size < 49