El‐Soussi 2015.

Study characteristics
Methods	Parallel‐group randomised controlled trial
Participants	60 participants Intubated men with COPD admitted to a pulmonary critical care unit (Egypt). Exclusion criteria: unconscious people and people with visual or hearing (or both) impairment.
Interventions	Intervention A communication board that was modified from the Othman board (2008) and EZ Boards translated into Arabic language. The board contained pictures and wording headings such as 'I am' and 'I want' with descriptive words listed under each picture. It also contained the Arabic alphabet and numbers 0–9 and included 2 drawings, 1 anterior view and 1 posterior view of the human body with a box entitled pain chart which contained descriptive expressions of pain. It also included a vertical pain scale from 0 to 10. The communication board was printed on A3 paper, stuck to rigid cardboard (49 cm height and 32 cm width), and covered with transparent plastic layer to easily disinfect. The participant kept the board at all times. The researchers trained nurses to use the board when the research team was not available. Control Usual care.
Outcomes	Patient satisfaction measured using a questionnaire developed by the authors and comprising 20 items rated on a 5‐point Likert scale (very dissatisfied to very satisfied). Patient communication level measured using the Patient Communication Tool modified from Patak and comprising 5 domains: communication methods; communication barriers; communication distress level; communication utility/usefulness; and communication partners. Intubation duration. ICU length of stay. Mortality.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No description of sequence generation. Further information sought but not obtained.
Allocation concealment (selection bias)	Unclear risk	No description of allocation concealment. Further information sought but not obtained.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Unable to blind due to nature of intervention.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Outcome assessors were not blinded as members of research team delivering the intervention.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Did not report on communication barriers that are mentioned as part of the Patient Communication Tool.
Selective reporting (reporting bias)	Low risk	No evidence of selective reporting.
Other bias	Unclear risk	No evidence of other bias. Funding source: none stated. Author conflict of interest: none stated.