Wikberg 2017.

Study characteristics
Methods	Randomised trial, Sweden
Participants	The trial took place at 22 Swedish PHCCs between March 2010 and December 2013. All 98 PHCCs in the region were invited to participate in the intervention; 22 agreed to participate. 258 Study participants were patients aged 18 and up who visited the PHCCs and were identified and diagnosed by a GP with a new episode of mild/moderate depressive disorder.
Interventions	The intervention consisted of using a patient depression self‐rating scale (MADRS‐S) in recurrent monthly consultations during the 3‐month intervention. Patients made 4 visits to their GPs, at which time they completed MADRS‐S to monitor changes in their depressive symptoms that were then discussed in the person‐centred consultation. MADRS‐S was used as a supplement to, rather than as a substitute for, TAU.   Intervention features Multiple complex feedback (multiple PROMs at multiple times)  PROM(s) used as intervention: Beck Depression Inventory‐II (BDI‐II), EQ‐5D, 12‐ item General Health Questionnaire (GHQ‐12) Constructs measured: Health related Quality of Life, Symptoms, Functioning Instrument categories/domains: Generic, 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): Unclear   Feedback features Format of PROMs feedback: Unclear How often information fed back: 4 times over 3 months Who information fed back to: Clinicians, Patients Information fed back: Scores, Previous scores, Interpretation guidance, Management recommendations
Outcomes	Main outcome: depression severity (BDI‐II), depression remission, quality of life (EQ‐5D), overall psychological well‐being (GHQ‐12), prescriptions for antidepressants, prescriptions for sedatives, sick leave, healthcare use.
Notes	The study was supported by the Department of Health. 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	The participants in the experimental and control groups were divided into groups based on random assignment.
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	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 reported.
Baseline characteristics similar	Unclear risk	Not reported.
Incomplete outcome data (attrition bias) All outcomes	High risk	1339 randomised, of whom 358 (26.7%) excluded due to not completing an outcome measure, or not returning for a second session.
Was study protected against contamination	High risk	Therapists was aware that the patient was a participant in the study.
Selective reporting (reporting bias)	Low risk	None apparent.