Rand 1988.

Study characteristics
Methods	Randomised trial, USA
Participants	32 residents and 1040 patients visiting a family practice site. Participants were mainly between the ages of 18 to 40 years and female
Interventions	Participants in the experimental group were provided feedback on the GHQ by the residents.   Intervention features Single simple feedback (one PROM at a single time) PROM(s) used as intervention: GHQ‐28 Constructs measured: Symptoms Instrument categories/domains: Domain/Disease specific (mental health)   Administration features Where PROMs administered: Clinical setting (e.g. waiting room, office, etc)  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
Outcomes	Main outcomes: psychiatric screening (GHQ), chart audit form (psychologic or psychiatric of condition, and patient demographics (sex, race, age))
Notes	The study was funded by University of Alabama and College of Community Health Sciences Research Grants Committees. The study period was not reported. The authors declared no conflicts of interest.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomisation method not specified.
Allocation concealment (selection bias)	High risk	Allocation concealment not possible due to cluster‐randomisation
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not possible to blind physicians
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	Low risk	Outcome measurements were similar at baseline.
Baseline characteristics similar	Low risk	Table is provided and paper states that no significant differences between groups were found.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Missing data were not mentioned in terms of how it was handled statistically
Was study protected against contamination	Low risk	Sites were randomised but it was not clear whether the sites were in contact with each other
Selective reporting (reporting bias)	Low risk	None apparent.