Yen 2004.

Clinical features and settings	Inclusion criteria: Patients with shoulder pain and suspected of rotator cuff tears Exclusion criteria: Not reported Duration of symptoms: Not reported Previous treatments: Not reported Care setting: Not reported
Participants	Place of study: Taiwan, China Period of study: Not reported Number of participants eligible: 50 participants Number of participants enrolled IT and RS: ‐ US and open surgery: 50 Data available for analyses: ‐ US and open surgery: 50 Age: mean 63 years (range 17 to 81 years) Male/Female: 26/24 Dominant arm: Not reported Nature of onset: Not reported
Study design	Primary objective: To prospectively compare the US and operative findings of rotator cuff tears Study design: Prospective accuracy cohort study Unclear whether consecutive recruitment Language: English
Target condition and reference standard(s)	Target conditions: Presence any rotator cuff tears Reference standard(s): 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 MHz linear transducer Technique: Longitudinal, transverse and oblique scans of the tendons were used Patient position: Probably patient seated with the arm in External rotation for scanning the subscapularis tendon Neutral position for the long head of the biceps tendon Internal rotation and with the patient's hand behind the back with extreme internal rotation for the supraspinatus tendon Flexion and adduction for infraspinatus and teres minor tendons ‐ Criteria for a positive result: Six US signs were used: non‐visualisation; Floating bright spots Focal depression Focal thinning Focal hypoechoic cleft Focal heterogeneous hypoechogenicity ‐ Time from symptoms to index test: Not reported ‐ Time from index test to reference standard: within 1 month
Follow‐up	Adverse events due to index test(s): Not reported Adverse events due to reference standard test(s): Not reported
Notes	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	Population was patients with suspected of having any rotator cuff tears The study was prospective It was unclear whether consecutive recruitment
Acceptable reference standard? All tests	Unclear	The reference standard was open surgery and the target condition was presence of any rotator cuff tears
Acceptable delay between tests? All tests	Yes	The reference standard was performed within 1 month after the index test
Partial verification avoided? All tests	Yes	All patients who received the index test went on to receive verification of their disease status using a reference standard
Differential verification avoided? All tests	Yes	All patients received the same reference standard regardless of the result of their index test
Incorporation avoided? All tests	Yes	The index test did not form part of the reference standard
Index test results blinded? All tests	Yes	The index tests were interpreted before and without knowledge of the reference standard results
Reference standard results blinded? All tests	No	The results of the index tests were known to the person interpreting the reference tests
Relevant clinical information? All tests	Unclear	Not reported
Uninterpretable results reported? All tests	Yes	The study was prospective and results were reported for all initially included participants
Withdrawals explained? All tests	Yes	No participants were excluded from the analysis
Learning curve / training reported of index test? All tests	Unclear	All of the procedures were performed by one sonologist and the findings were interpreted by two or three sonologists in consensus prior to surgery
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	Yes	The study reported the definition of a positive index test result

<: less than
 >: more than
 IT: Index test
 MHz: Megahertz
 RS: Reference standard
 T: Tesla
 T1‐weighted: Short TR and short TE sequences
 T2‐weighted: Long TR and long TE sequences
 TE: Echo time
 TR: Repetition time