Singh 2008.

Study characteristics
Methods	RCT. Parallel design with 2 arms. Duration: 3 months. Location: India.
Participants	Inclusion criteria: adults with chronic pancreatitis and undernourished, BMI < 18.5 kg/m² or > 10% weight loss in previous 6 months. Exclusion criteria: clinically apparent steatorrhoea, pancreatic cancer, biliary obstruction, undergoing endoscopic or surgical therapy, uncontrolled diabetes, acute exacerbation of pancreatitis, large pseudocysts, currently consuming alcohol, opioid addicts, comorbid condititions eg. chronic liver disease. Number randomised: 60 participants (intervention group, n = 31; intervention group 2, n = 29). Attrition: 6 dropouts (intervention group, n = 4; intervention group 2, n = 2). Gender split: 50 males, 10 females. Age: mean (SD), intervention group 1, 28 (10) years; intervention group 2, 32 (10) years. Nutritional status: mean (SD) BMI: intervention group 1, 16.7 (1.6) kg/m2, intervention group 2, 17.2 (1.7) kg/m2.
Interventions	Intervention (intervention group 1): particpants received ONS in the form of a nutritional supplement enriched with medium chain triglycerides to meet predicted energy requirements. Intervention (intervention group 2): participants received dietary advice in the form of dietary advice from a dietitian to meet predicted energy requirements.
Outcomes	BMI*, weight* TSF*, MAMC*, energy and protein intake, nitrogen balance, faecal fat, pain score.
Publication details	Language: English. Funding: Indian Council for Medical Research. Publication status: peer‐reviewed journal.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated random number list.
Allocation concealment (selection bias)	Low risk	Carried out by individual not otherwise involved in the study.
Blinding (performance bias and detection bias) Clinical outcomes	Low risk	Outcome assessment blinded to treatment.
Blinding (performance bias and detection bias) Functional outcomes	Low risk	Outcome assessment blinded to treatment.
Blinding (performance bias and detection bias) Nutritional outcomes	Low risk	Outcome assessment blinded to treatment.
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	Low risk	All outcome assessment was assessed blinded to group allocation. Quote: "the person assessing outcome was blinded to the treatment the patient was receiving".
Incomplete outcome data (attrition bias) All outcomes	Low risk	Fully reported and similar between groups: 4/31 (13%) intervention group at 1.5 months, 2/29 (7%) control group at 1.5 months. But all included in the final analysis.
Selective reporting (reporting bias)	Unclear risk	No protocol identified. All outcomes reported but not in a format usable for meta analysis. Data on change in weight, TSF, MAC and energy intake were reported as mean (SD) at baseline and mean (SD) at end of intervention, therefore mean change (SD) obtained from authors.
Other bias	Low risk	Baseline variables given, groups similar at baseline.