Summary of findings.

Summary of findings table

To determine if adding an open laparoscopy to the diagnostic work‐up of patients suspected of advanced ovarian cancer is accurate in predicting resectability of disease? Population: Patients suspected of advanced ovarian cancer Prior testing: Standard diagnostic work‐up consisting of clinical and radiological evaluation Index tests: Open diagnostic laparoscopy after conventional work‐up. Target condition: Tumour which could not be resected at laparotomy (extensive disease) Reference standard: Explorative laparotomy. Studies: Cohort studies (5) and development/validation prediction model (n = 3)
Cut off test‐positivity laparoscopy	Sensitivity range of estimates	Specificity range of estimates	Prevalence of positive test result (range)	Prevalence of negative test result (range)	Negative Predictive Value (range)	Number of  participants	Quality (QUADAS)
Prediction of surgery result based on different criteria of unresectability or estimation 5 studies, no pooled analysis	0.70 to 0.71*	1.00*	41% (27%‐64%)	56% (36%‐73%)	69%‐96%	295	High risk of bias1 Applicability concerns2
PIV ≥ 8   2 studies, no pooled analysis	0.30‐0.70	0.89‐1.00	28% (10%‐40%)	72% (65%‐90%)	44%‐76%	165	Low risk of bias High concerns Applicability2

* Only two studies performed the reference standard in all patients, sensitivity and specificity are based on these two studies ¹Four studies did not perform the reference standard in test‐positive patients ² Applicability concerns based on inclusion of not only patients planned for primary cytoreductive surgery or conventional diagnostic work‐up not conclusive