Bruera 2004.

Study characteristics
Methods	Double‐blind, parallel‐arm trial 5 international centres Study duration: 7 days
Participants	51 participants (25 intervention, 26 control) with advanced cancer and chronic nausea (> 2 weeks) resulting from advanced cancer despite treatment with metoclopramide at a minimal daily dose of 40 to 60 mg for 2 days
Interventions	Intervention: 20 mg/day dexamethasone orally in addition to metoclopramide (60 mg/day orally) Control: placebo in addition to metoclopramide (60 mg/day)
Outcomes	Pain, appetite, fatigue and nausea, measured on a 0 to 10 numerical rating scale (NRS) (0 = symptom absent, 10 = worst possible symptom) Quality of life: physical well‐being, social well‐being, functional well‐being, emotional well‐being Toxicity assessment: presence or absence of ankle oedema, insomnia, restlessness or other symptoms (patient‐rated)
Notes	Pain secondary outcome measure. Nausea as primary endpoint Pain intensity at baseline low in both arms. Authors therefore query meaningfulness of pain as outcome measure
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomised, method not specified
Allocation concealment (selection bias)	Low risk	Capsules containing both drugs identical in appearance, randomisation in pharmacy
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blind
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Double‐blind
Incomplete outcome data (attrition bias) All outcomes	Low risk	3 of 25 patients receiving dexamethasone dropped out 5 of 26 patients receiving placebo dropped out
Selective reporting (reporting bias)	Low risk	None detected
Other bias	High risk	Sample size: 51 participants; < 50 participants per treatment arm