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. 2020 Apr 15;2020(4):CD011621. doi: 10.1002/14651858.CD011621.pub4

Bell 2015.

Study characteristics
Methods Randomised, 2 parallel groups; simulation study
Participants N = 8, nurses (6), physicians 2; women 7/8
Intervention: 4, control: 4
Volunteer healthcare providers, no further details provided
Location: USA
Interventions Intervention: different types of PPE compared: commercially available PPE: neck‐to‐ankle coverall (type not reported), water impermeable surgical gown, knee‐length impermeable leggings, Stryker hood, double gloves with outer arm‐length surgical gloves, N95 masks; meeting CDC recommendations; each participant was assisted in PPE donning by an experienced trainer.
Control: local, readily available attire: 2 plastic gowns worn over the front and the back of the torso, rain‐suit pants and hood, spark‐shield as face‐cover, ankle length shoe covers, double gloves with outer arm‐length surgical gloves, N95 masks; meeting CDC recommendations; each participant was assisted in PPE donning by an experienced trainer.
Outcomes Contamination: measured in mL of fluorescent agent with LED black light after doffing.
Random order of 2 types of exposure: high volume or standard. High volume meant 100 mL of fluorescent agent splashed on the torso. Standard meant working on a manikin contaminated with fluorescent agent. Fluorescent liquid mimicked body fluids and consisted of fluorescent powder, clothes detergent, fluorescent tablets
Notes No funding or conflict of interest reported
Apparently tape was used to put attire together; this resulted in more difficult doffing but no figures reported; costs of locally available equipment was USD 36 US, that of commercial material not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "randomized to one of two PPE ensembles"
Allocation concealment (selection bias) Unclear risk Not reported
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk Not reported
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Not reported
Incomplete outcome data (attrition bias)
All outcomes Low risk No incomplete outcome data
Selective reporting (reporting bias) High risk Contamination outcomes reported but no separate outcomes for high or normal exposure, however small sample and no statistical analysis by study authors
Other bias Low risk No indication