Study:Ramdial 2002.Outcome: death at 32 months
Confounding domains	Measured variable(s)	Is there evidence that controlling for this variable was unnecessary?	Is the confounding domain measured validly and reliably?	OPTIONAL Is failure to adjust for this variable expected to favour intervention or comparator
Severity of PDH	Organ involvement	No	Not according to standard classification	—
Severity of HIV	CD4 count	No	Yes	—
Comorbidities and comedications	Not reported	No	—	—
Cointerventions	Is there evidence that controlling for this cointervention was unnecessary?		Is presence of this cointervention likely to favour outcomes in the intervention or comparator?
ART at time of PDH diagnosis	No. ART use was not reported.		—
Supportive therapy	No. Not reported.		—
Bias domain	Signalling questions	Comments		Risk of bias judgement
Bias due to confounding	1.1–1.8	Confounders not addressed with respect to treatment regimens. Descriptive account provided of management of participants without detail on severity of conditions, comedications, or comorbidities. No information provided on time to treatment or duration of treatment.		Critical
Bias in participant selection	2.1–2.5	Some of these cases are likely to have been Emergomyces.		—
Bias in classification of intervention	3.1–3.3	—		—
Bias due to deviations from intended intervention	4.1–4.6	—		—
Bias due to missing data	5.1–5.5	—		—
Bias in measurement of outcomes	6.1–6.4	—		—
Bias in selection of reported result	7.1–7.3	—		—
Overall bias				Critical