Cruz‐Correia 2007.

Methods	Randomised cross‐over study
Participants	21 adults aged 16 to 65, from Porto, Portugal, with a previous medical diagnosis of asthma were included
Interventions	Patients received web‐based monitoring for 4 weeks then paper monitoring for 4 weeks or vice versa in random sequence ‐ a cross‐over trial. The web‐based application was named "Portal for Assessment and Self‐management of Asthma" and it included information on frequently asked questions, asthma self‐management and enabled patients to fill in the Asthma quality of life test and record PEF/FEV1. The technology provided immediate feedback, automatic messages and alerts to both patients and doctors to enable therapeutic decisions. This information contributed to an interactive asthma plan. Control: The control group recorded PEF/FEV1 in a paper diary and had a paper based action plan
Outcomes	Outcome measures 1. Patient opinions, in the form of positive and negative comments, reports of problems relating to the internet connection, importance of different features that the different diaries offered and patients' willingness to monitor their asthma 2. The time taken to fill in the internet and paper diaries 3. Adherence to monitoring tools
Notes	—
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	“Randomisation was performed using a computer generated algorithm”
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes	High risk	No blinding, both patients and data collectors unblinded
Incomplete outcome data (attrition bias) All outcomes	High risk	Two patients dropped out, one lost access to the Internet during the study period the other moved to another city
Selective reporting (reporting bias)	High risk	Data collected on quality of life but not reported
Other bias	High risk	Some patients reported filling in their paper diaries for several days at once, this was not possible with the Internet system