Cross 2012.

Study characteristics
Patient sampling	Design: Prospective diagnostic test accuracy Setting: UK Accrual dates: Jan 2000 to Dec 2010 No participants: 1445 No assessed: 1439 Inclusion criteria: Women with possible ovarian malignancy were included. Women with obvious disseminated malignancy (FIGO stage III/IV) were excluded. Included previous histological diagnosis: yes, 6 cases
Patient characteristics and setting	Women with possible ovarian malignancy were included. Women with obvious disseminated malignancy (FIGO stage III/IV) were excluded.Tertiary centre, UK.
Index tests	Two pieces of tissue taken for FS staining and reporting by consultant pathologist. Report was then phoned through to surgeon who used the info to determine the extent of surgery.
Target condition and reference standard(s)	Malignant or borderline on PS.
Flow and timing	FS before PS.
Comparative
Notes	Women with borderline and malignant diagnosis underwent surgical staging.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Yes
Was the sample representative of patients in practice (90% stage I/II with RMI>200)?	Yes
		Low	Low
DOMAIN 2: Index Test All tests
Were the index tests interpreted without knowledge of the reference standard?	Yes
Were the index tests Interpreted by consultant or specialist gyn‐onc pathologist?	Yes
		Low	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?	Unclear
		Unclear	Low
DOMAIN 4: Flow and Timing
Did all patients receive a reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Were un‐interpretable/intermediate test results reported?	Yes
Were withdrawals from the study explained?	Yes
		Low