Jousimaa 2002.

Methods	Study design: C‐RCT Unit of allocation: physician Type of comparison: paper‐based PEM vs. CD‐Rom PEM group A: computerised guidelines group B: paper‐based guidelines
Participants	Physicians Clinical speciality: general practice/family medicine Level of training: newly qualified physicians in their last 2‐year training period (during which they work independently and are responsible for their own clinical decisions) Setting/country: general practice/Finland
Interventions	The PEM studied in this report was the Physician's Desk Reference and Database (now re‐named Evidence‐Based Medicine Guidelines), a collection of Finnish clinical practice guidelines. The over 1100 guidelines were written by GPs in cooperation with experts from other specialities
Outcomes	9 process outcomes: proportion of consultation decision compliant with guidelines (laboratory examinations) proportion of consultation decision compliant with guidelines (radiological examinations) proportion of consultation decision compliant with guidelines (physical examinations) proportion of consultation decision compliant with guidelines (other examinations) proportion of consultation decision compliant with guidelines (procedures) proportion of consultation decision compliant with guidelines (physiotherapy) proportion of consultation decision compliant with guidelines (non‐pharmacological treatments) proportion of consultation decision compliant with guidelines (pharmacological treatment) proportion of consultation decision compliant with guidelines (referrals)
Notes	‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote, pg. 588: "students agreeing to participate in the study were randomized centrally using computer‐generated numbers to receive either computerized or textbook‐based guidelines"
Allocation concealment (selection bias)	Low risk	COMMENT: the unit of allocation is by physician and allocation is performed on all units at the start of the study
Baseline characteristics similar (selection bias)	Low risk	Quote, pg. 589: "the baseline characteristics of both study groups were similar (Table 1)" COMMENT: the baseline characteristics of the intervention and control groups were reported and similar
Baseline outcome measurements similar (selection bias)	Unclear risk	No information was provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	The reasons for loss to study were similar and the proportions were similar, 6/72 = 8.3% in intervention and 3/67 = 4.5% in control group
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote, pg. 589: "the anonymous patient records were then evaluated by one author (JJ, experienced primary care physician) blinded to the study group (computer or textbook, information searching or non‐information searching consultation)" COMMENT: the authors state explicitly that the primary outcome variables were assessed blindly
Contamination protection (contamination bias)	Unclear risk	COMMENT: professionals were possibly allocated within a clinic or practice and it is possible that communication between intervention and control professionals could have occurred
Selective reporting (reporting bias)	Low risk	All relevant outcomes in the methods section were reported in the results section
Other bias	Low risk	No evidence of other risks of bias