Anbar 2014.

Study characteristics
Methods	Prospective RCT (unblinded). Parallel design. Duration: data collected up to 14 days or discharge (including pre‐op period). Location: single centre (Petah Tikva, Israel).
Participants	Inclusion criteria: aged > 65 years and admitted within 48 hours of injury to an orthogeriatric unit following hip fracture; orthopedic surgery considered the treatment of choice. Exclusion criteria: presented to hospital > 48 hours after injury, receiving steroids and/or immunosuppression therapy; presence of active oncologic disease, multiple fractures, diagnosed dementia or in the event that participants required supplemental nasal oxygen which precludes the measurement of REE. Number randomised: 50 participants: intervention group n = 22; control group n = 28. Gender split: intervention group 6 (27%) male and 16 (73%) female; control group 11 (39%) male and 17 (61%) female. Age: mean (SD) intervention group 82.3 (6.1) years; control group 83.7 (6.4) years. Nutritional status: BMI, mean (SD): intervention group 25.2 (3.2) kg/m²; control group 24.7 (4.4) kg/m².
Interventions	Intervention: participants received dietary advice plus ONS in the form of a hospital‐prepared diet plus ONS (355 kcal/237 mL and 13.5 g protein or 237 kcal/237 ml and 9.9 g protein/237 mL), adjusted to meet energy goals which were determined by repeated resting energy expenditure measurements using indirect calorimetry; participants, family and caregivers educated regarding the importance of nutritional support and more attention was given to personal food preferences. Control: participants received no dietary advice and no ONS in the form of usual hospital food (standard or texture adapted) and a fixed dose of oral nutritional supplement if already prescribed prior to hospitalisation.
Outcomes	Primary outcomes Postoperative complications (i.e. surgical, infectious, cardio‐vascular, gastro‐intestinal, deep vein thrombosis and new pressure sores). Length of hospital stay. Secondary outcomes Energy intake. Calculated energy balance.
Publication details	Language: English. Funding: not stated. Publication status: peer‐reviewed journal.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: Randomisation was performed using a concealed, computer‐generated program.
Allocation concealment (selection bias)	Low risk	Quote: use of a consecutively numbered opaque envelope.
Blinding (performance bias and detection bias) Clinical outcomes	High risk	Quote: Patients were examined daily by the research nurse and attending physician for the presence of postoperative complications.
Blinding (performance bias and detection bias) Functional outcomes	High risk	Not blinded and lack of blinding might have affected assessment of outcomes.
Blinding (performance bias and detection bias) Nutritional outcomes	High risk	Quote: The nutrient intake of each patient was monitored by the research team on a daily basis.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not blinded and likely that researchers and participants were aware of group allocation as this was a nutritional intervention. It is possible that assessment of some outcomes was influenced by lack of blinding.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Some outcome assessors were aware of group allocation and this might have affected assessment of some outcomes.
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants completed the study with no drop‐outs.
Selective reporting (reporting bias)	Unclear risk	No study protocol identified, thus unable to judge whether all planned outcomes were reported.
Other bias	Low risk	Baseline characteristics were similar in both groups.