De Candia 2002.

Clinical features and settings	Inclusion criteria: Participants with clinical suspicion of rotator cuff tear who underwent surgery Exclusion criteria: Not reported Duration of symptoms: Not reported Previous treatments: Not reported Care setting: Not reported
Participants	Place of study: Udine, Italy Period of study: January 2000 to December 2000 Number of participants eligible: 157 participants Number of participants enrolled IT and RS: ‐ US and surgery: 71 participants Data available for analyses: ‐ US and surgery: 71 participants Age (range): 34 to 80 years Male/Female: 31/40 Dominant arm: Not reported Nature of onset: Not reported
Study design	Primary objective: To determine the values of the US real time compound imaging in the evaluation of supraspinatus tendon in subacromial impingement disease Study design: Prospective, accuracy cohort study Unclear whether consecutive recruitment Language: English
Target condition and reference standard(s)	Target conditions: Presence of any rotator cuff tears, full thickness tears and partial thickness tears Reference standard(s): Surgery, unclear whether arthroscopy or open surgery ‐ Description of technique: Not reported ‐ Criteria for a positive result: Not reported
Index and comparator tests	Index test(s): US ‐ Description of technique: Scanner: 7 to 12 MHz linear‐array probe applying the soon CT digital algorithm Technique: Images were obtained in static and dynamic evaluations as described in (Martino 1998; Teefey 2000) Patient position: Static evaluation was performed on the patient’s arm in standard position; dynamic evaluation was performed first with the patient’s arm positioned from the internal rotation and extended position to abduction and internal rotation (forearm flexed and the back face of fingertips pointing to the scapula); the second part of the evaluation was performed by moving the patient's arm in adduction and keeping the internal rotation ‐ Criteria for a positive result: Not reported ‐ Time from symptoms to index test: Not reported ‐ Time from index test to reference standard: Index test was performed on the day before reference standard
Follow‐up	Adverse events due to index test(s): Not reported Adverse events due to reference standard test(s): Not reported
Notes	Part of population of this study was also reported in De Candia 2003 Although De Candia 2003 is more updated than this study, there were no extra data available to be included in the analyses The rotator cuff tears were focused on only supraspinatus tendon tears A two‐by‐two table of the ITs and RS was given, which tallied with the reported summary data
Table of Methodological Quality
Item	Authors' judgement	Description
Representative spectrum? All tests	Unclear	Unclear whether consecutive recruitment
Acceptable reference standard? All tests	Unclear	The reference standard was surgery (unclear whether arthroscopy or open surgery) and the target conditions were presence of any rotator cuff tears, full thickness tears and partial thickness tears
Acceptable delay between tests? All tests	Yes	Index test was performed on the day before reference standard
Partial verification avoided? All tests	No	Not all the patients who received the index test underwent a reference standard to verify their true disease status Of the 157 eligible participants, only 71 (45.2%) underwent to reference standard
Differential verification avoided? All tests	No	The result of the index test probably influenced the choice of the reference standard
Incorporation avoided? All tests	Yes	The index test did not form part of the reference standard
Index test results blinded? All tests	Unclear	Insufficient information was given to permit judgement
Reference standard results blinded? All tests	No	The results of the index tests were probably known to the person interpreting the reference tests
Relevant clinical information? All tests	Unclear	Not reported
Uninterpretable results reported? All tests	No	The results of 86 (54.8%) patients were not reported
Withdrawals explained? All tests	No	Some of the eligible patients who entered the study did not complete it and these patients were not accounted for
Learning curve / training reported of index test? All tests	Unclear	The interpreters of index tests were two radiologists; however, the training/expertise was not described
Learning curve / training reported of reference standard? All tests	Unclear	Insufficient information was given to permit judgement
Index test criteria for a positive test result reported? All tests	No	Not reported