Turpie 1990.

Study characteristics
Methods	Allocation: random Double blind Exclusions after randomisation: nil Losses to follow‐up: 37
Participants	Country: Canada Participants: 83 Age: < 75 years Sex: not described Inclusion criteria: venographically confirmed proximal DVT of lower limb duration < 7 days Exclusion criteria: bleeding dysfunction; active bleeding; peptic ulcer; stroke or intracranial process < 2 months; surgery, trauma, childbirth, biopsy, vessel puncture < 7 days
Interventions	Treatment: IV heparin 5000 U bolus then 30,000 U/24 hours, adjusted for 7 ‐ 10 days Phase 1: two chain tPA 0.5 mg/kg IV over 4 hours Phase 2: one chain tPA 0.5 mg/kg IV over 8 hours and repeated in 24 hours Control: identical placebo to tPA depending on phase, plus heparin as above Co‐treatment: warfarin commenced for 3 months
Outcomes	24 ‐ 48 hours: clot lysis; bleeding 3 years: post‐thrombotic syndrome
Funding	This study was supported by a grant (MA 9872) from the Medical Research Council of Canada
Declaration of interests	Not reported
Notes	22 died, 15 "not available" for intermediate to late follow‐up
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"Randomly allocated" no further details
Allocation concealment (selection bias)	Unclear risk	Not described clearly
Blinding of participants and personnel (performance bias) All outcomes	Low risk	"Identical appearing placebo"
Blinding of outcome assessment (detection bias) All outcomes	Low risk	"Venograms interpreted by an independent panel without knowledge of the clinical findings or the treatment group"
Incomplete outcome data (attrition bias) All outcomes	Low risk	All reported
Selective reporting (reporting bias)	Low risk	All reported
Other bias	Low risk	None