German 1987.

Study characteristics
Methods	Randomised trial, USA
Participants	809 adults recruited from general practices who had a 'positive' score on the GHQ.
Interventions	Feedback of depression scores reported to the physician.   Intervention features Single simple feedback (one PROM at a single time) PROM(s) used as intervention: General Health Questionnaire (GHQ) Constructs measured: Symptoms, Functioning Instrument categories/domains: Domain/Disease specific (mental health)   Administration features Where PROMs administered: Clinical setting How administered: Interviewer‐administered Format of PROMs questionnaire(s): Paper   Feedback features Format of PROMs feedback: Paper How often information fed back: Once Who information fed back to: Clinicians Information fed back: Scores, Interpretation guidance
Outcomes	Main outcome: number of enrolled on treatment program. Other outcomes: percentage of patients attending counselling, percentage of patients attending social agency contact, percentage of patients with psychotropic drugs noted or prescribed, referral to mental health specialist or other agency.
Notes	The study was supported in part by contract 278‐81‐0026(DB) from the National Institute of Mental Health to the Health Services Research and Development Center, Department of Health Policy and Management, School of Hygiene and Public Health, The Johns Hopkins University. The study took place between December 1981 and March 1982. No conflicts of interest are reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Random samples were taken from each day's appointment list.
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	High risk	Due to nature of intervention not possible to blind patients and personnel.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Due to nature of the intervention blinding of outcomes not possible: PROM used for feedback also used to assess outcome, patients were aware they received the intervention.
Baseline outcome measurements similar	Unclear risk	Not clearly reported
Baseline characteristics similar	Unclear risk	Not clearly reported
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Not clearly reported
Was study protected against contamination	Low risk	Control group had no access to the intervention.
Selective reporting (reporting bias)	Low risk	All relevant outcomes in the methods section are reported in the results section