Rogers 1992.

Study characteristics
Methods	RCT. Parallel design with 2 arms. Duration: 4 months. Location: USA.
Participants	Inclusion criteria: adults with COPD and weight < 90% of IBW and FEV1/FVC < 0.6. Exclusion criteria: recent (within 8 weeks) exacerbation of COPD, diabetes, thyroid dysfunction, malabsorption, alcoholism, myopathic disease or neoplastic disease, received nutritional supplements in the previous 3 months, corpulmonale, congestive heart failure. Number randomised: 28 participants (intervention group, n = 15; control group, n = 12). Attrition: 1 withdrawal in the control (no advice) group. Gender split: not reported. Age: mean (SE), 62 (2.0) years. Nutritional status: mean (SE) % IBW, intervention 77.8 (1.6) %; control 78.6 (2.0) %.
Interventions	Intervention: participants received dietary advice plus ONS if required in the form of nutritional counselling to achieve a balanced meal plan plus supplements as needed; advice provided during 4‐week inpatient phase and then at each outpatient visit. Control: participants received no dietary advice and no ONS in the form of no dietary advice.
Outcomes	Weight*, TSF*, MUAC*, grip strength*, respiratory function*, QoL* (Sickness Impact Profile (SIP)).
Publication details	Language: English. Funding: the National Heart, Lung and Blood Institute, the American Lung Association of Southwestern Pennsylvania, Clinical Research Unit of Presbyterian‐University Hospital and Ross Laboratories. Publication status: peer‐reviewed journal.
Notes	Additional data and information awaited from authors. No data on QoL was presented, only that the difference was not significant.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Described as randomised, method not stated.
Allocation concealment (selection bias)	Unclear risk	Method not stated.
Blinding (performance bias and detection bias) Clinical outcomes	Low risk	The study was unblinded. However, this is unlikely to influence clinical outcomes.
Blinding (performance bias and detection bias) Functional outcomes	High risk	The study was unblinded. Functional outcomes could have been influenced by lack of blinding.
Blinding (performance bias and detection bias) Nutritional outcomes	Unclear risk	No nutritional outcomes reported.
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	Unclear risk	Judged to be unclear, as low risk for clinical outcomes and high risk for functional outcomes.
Incomplete outcome data (attrition bias) All outcomes	Low risk	1 withdrawal in the no advice group. Reason not given.
Selective reporting (reporting bias)	Unclear risk	No study protocol identified, thus unable to judge whether all planned outcomes were reported. All specified outcomes were reported in a format not suitable for entry into meta‐analysis. Change in weight, TSF, MAMC and handgrip strength are reported as mean (SD) at the start and end of intervention with a P value. No data obtained from authors therefore mean change (SD) derived using data in the paper.
Other bias	Low risk	Baseline variables given, groups similar at baseline.