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| | TRITON-TIMI 38 | TRILOGY ACS | PLATO |
| | Authors judgement | Support for judgement | Authors judgement | Support for judgement | Authors judgement | Support for judgement |
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| Random sequence generation (selection bias) | Unclear risk of bias | No information provided on randomization protocol aside from stratification based on presenting symptoms | Unclear risk of bias | No information provided on randomization protocol aside from stratification by age, country, and prior clopidogrel treatment status | Low risk of bias | Patients randomised using computer software (treating physician could not influence) operating on a randomisation schedule managed by a group not involved in the trial |
| Allocation concealment (selection bias) | Low risk of bias | Double-dummy trial method used | Low risk of bias | Double-dummy trial method used | Low risk of bias | Double-dummy trial method used |
| Blinding of participants and personnel (performance bias) | Unclear risk of bias | Trial is “double blinded" but does not refer explicitly who is blinded | Unclear risk of bias | Trial is “double blinded" but does not refer explicitly who is blinded | Unclear risk of bias | Trial is “double blinded" but does not refer explicitly who is blinded |
| Blinding of outcome assessment (detection bias) | Unclear risk of bias | Trial is “double blinded" but does not refer explicitly who is blinded | Unclear risk of bias | Trial is “double blinded" but does not refer explicitly who is blinded | Unclear risk of bias | Trial is “double blinded" but does not refer explicitly who is blinded |
| Incomplete outcome data (attrition bias) | Low risk of bias | Intention to treat analysis, only 0.1% of patients lost to followup, raw data for safety and efficacy endpoints provided for overall cohort | Low risk of bias | A similar proportion of the prasugrel and clopidogrel groups (76% versus 78%, resp.) continued to receive the study drug throughout the followup. A small proportion (120 patients from 4 sites) were excluded from analysis due to breaking protocol, this was done prior to unblinding, and therefore the effects were unknown to the authors. | Low risk of bias | Analysis carried out on entire prespecified stratum. Similar proportions of study drug (14.6) and control drug (14.0) treated patients dropped out of the study. Intention to treat analysis |
| Selective reporting (reporting bias) | Low risk of bias | Study protocol available and all primary, secondary and safety outcomes are reported | Low risk of bias | Study protocol available and all primary, secondary, and safety outcomes are reported | Low risk of bias | Study protocol available and all primary, secondary, and safety outcomes are reported |
| Other sources of bias | Low risk of bias | The study appears to be free of other sources of bias | Low risk of bias | The study appears to be free of other sources of bias | Low risk of bias | The study appears to be free of other sources of bias |
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