Gold 1989.

Study characteristics
Methods	Randomised trial, USA
Participants	599 non critical emergency department patients Mean age unknown Female 61.2%
Interventions	Providing the results of a psychiatric screening instrument (GHQ) to emergency physicians.   Intervention features Single simple feedback (one PROM at a single time)  PROM(s) used as intervention: The General Health Questionnaire‐28 (GHQ‐28) Constructs measured: Symptoms, Functioning Instrument categories/domains: Domain/Disease specific (mental health)   Administration features Where PROMs administered: Clinical setting How administered: Self‐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: patient judged to have a psychiatric problem (psychiatric diagnosis and/or psychosocial referral) Other outcomes: acceptance rate of psychosocial referral, medical management (number of laboratory test or medical/surgical referrals)
Notes	The study was funded by National Institute of Mental Health (grant# RO 1 MH 3703). The study was conducted between 1 January 1983 and 1 February 1984. No statement was given concerning conflicts of interest.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Paper only states quote "Patients were assigned to the control or intervention group based on the time they presented to the ED."
Allocation concealment (selection bias)	Unclear risk	Not stated in text
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	There was only one measure ‐ i.e. no baseline and follow‐up.
Baseline characteristics similar	Unclear risk	Not reported.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Not reported
Was study protected against contamination	Unclear risk	The physicians would have had a different process for intervention patients ‐ but it was unclear as to whether they knew what to expect
Selective reporting (reporting bias)	Unclear risk	Unclear whether selective reporting took place