Deffieux 2006

Study characteristics
Patient sampling	cross‐sectional study, enrolment not reported
Patient characteristics and setting	Sample size: 15 patients Mean age: 54 years (range 37‐75) Presentation: Patients with primary ovarian cancer FIGO stageIIIC/IV suspected of peritoneal carcinomatosis and in whom preoperative evaluation was unsatisfactory to define the possibility of achieving a complete cytoreduction, no massive disease at diaphragm/xiphoid or liver pedicle, planned for PDS Diagnostics before index test: physical/gynaecological examination, CT abdomen/pelvis, Thorax x‐ray/CT, Kind of surgery: PDS 11; IDS 0 No debulking surgery 4 Setting: Department of gynaecology hospital Tenon, Paris, France
Index tests	Open diagnostic laparoscopy; examination of the whole abdomen, focus on involvement of small bowel, liver pedicle and upper right diaphragmatic dome. Cut‐off test‐positivity: having one or more of the criteria for unresectability Complications of index test: none
Target condition and reference standard(s)	Target condition: unresectable carcinomatosis Criteria for target condition: involvement of bowel mesentery/bulky disease diaphragm/massive involvement of liver pedicle Reference standard: Laparotomy. Test operators: not reported Percentage of patients in whom reference standard performed:73% Unresectable disease at laparotomy: 1
Flow and timing	Time between reference standard and index test: 0 day.
Comparative
Notes	15 patients underwent diagnostic laparoscopy, of these 11 were considered operable. Ten of the patients were indeed successfully operated and one had too extensive disease. The other four patients were treated with NACT.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Did the study avoid inappropriate exclusions?	Unclear
Were the patients suspected of advanced ovarian cancer by conventional diagnostic work‐up?	Yes
Were patients planned for primary cytoreductive surgery after conventional diagnostic work‐up?	Yes
			Low
DOMAIN 2: Index Test Diagnostic open laparoscopy
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
Were the same clinical data available when test results were interpreted as would be available when the test is used in practice?	Yes
Did the study provide a clear definition of what was considered to be a "positive "result for the index test?	Yes
			Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	No
			Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Were all patients included in the analysis?	Yes
Did patients receive the same reference standard regardless of the index test result?	No