Table 2.

Summary of risk of bias in studies reporting diagnosis of S. pneumoniae community-acquired pneumonia based on BinaxNOW^a

First author and year (reference)	Representative patient spectrum?b	Low risk of bias in implementing index test?c	Low risk of bias in implementing reference test?d	Low risk of bias in patient flow?e
Sordé 2011 (24)	Yes	No	Yes	No
Segonds 2010 (26)	Yes	No	No	No
Garcia-Suarez 2007 (32)	Yes	No	Yes	Yes
Lasocki 2006 (36)	No (all ICU)	No	No	No
Tzeng 2006 (37)	Yes	No	No	No
Lauderdale 2005 (38)	Yes	No	No	No
Ishida 2004 (4)	Yes	Yes	No	Yes
Róson 2004 (40)	Yes, minority ambulatory	No	No	No
Stralin 2004 (41)	Yes	Yes	Yes	No
Butler 2003 (42)	Yes	No	No	No
Marcos 2003 (6)	Yes	No	No	Yes
Burel 2001 (44)	Yes	No	No	No
Shibli 2010 (23)	Yes	No	No	Yes
Charles 2008 (28)	Yes	No	No	No
Weatherall 2008 (30)	Yes	Yes	No	Yes
Diaz 2007 (31)	Yes	No	No	No
Kobashi 2007 (33)	Yes	Yes	No	No
Andreo 2006 (34)	Yes	No	No	No
Ercis 2006 (35)	Yes	No	No	No
Genne 2006 (3)	Yes	No	No	No
Van der Eerden 2005 (39)	Yes	No	No	Yes
Farina 2002 (43)	Yes	No	No	No
Murdoch 2001 (45)	Yes	No	No	Yes
Johansson 2010 (22)	Yes	No	No	Yes
Perello 2010 (25)	No (all HIV)	No	No	No
Smith 2009 (27)	Yes	No	No	No
Hohenthal 2008 (29)	Yes	No	No	No

^aStudies are ordered by date of publication within reference standard. The response under each column heading is reported as “no” if any one of the constituent questions was answered with a “no.”

^bWas the spectrum of patients representative of the patients who will receive the test in practice?

^cWere the reference standard results interpreted without knowledge of the results of the index test? Were the index test results interpreted without knowledge of the results of the reference standard? Were the same clinical data available when test results were interpreted as would be available when the test is used in practice? Were uninterpretable/intermediate test results reported?

^dWas the reference standard likely to classify the target condition correctly? (In all instances, this was no, as the reference standard was known to be imperfect.) Was the reference standard independent of the index test (i.e., the index test did not form part of the reference standard)? (In all instances this was yes, as independence was one of the inclusion criteria for the meta-analysis.) Were the index test results interpreted without knowledge of the results of the reference standard?

^eWas the time period between reference standard and index test short enough to be reasonably sure that the target condition did not change between the two tests? Did the whole sample, or a random selection of the sample, receive verification using the intended reference standard? Did patients receive the same reference standard irrespective of the index test result? Were withdrawals from the study explained?