Fernandez‐Castillo 1995.

Study characteristics
Patient sampling	Sample size: 109 Females: Not stated Age: Not stated
Patient characteristics and setting	Patients with potentially resectable pancreatic adenocarcinoma (on CT scan) without gastric outlet obstruction Setting: Surgical centre in the USA
Index tests	Diagnostic laparoscopy Criteria for positive diagnosis: Biopsies of lesions suspicious of metastases
Target condition and reference standard(s)	Target condition: Unresectability Reference standard: Laparotomy for patients with no evidence of metastases on laparoscopy; biopsy with histolopathological confirmation of spread for patients with suspected metastases Criteria for positive diagnosis: Not stated
Flow and timing	Number of indeterminates for whom the results of reference standard were available: not stated Number of patients who were excluded from the analysis: 5 (4.2%)
Comparative
Notes
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?	No
		High	Low
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
		Low	Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Unclear
Were the reference standard results interpreted without knowledge of the results of the index tests?	No
		Unclear	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Unclear
Did all patients receive the same reference standard?	No
Were all patients included in the analysis?	No
		High