Alfonso 2003.

Study characteristics
Patient sampling	Type of study: retrospective study. Consecutive or random sample: unclear.
Patient characteristics and setting	Sample size: 157. Females: 63 (40.1%). Age: 67 years. Presentation: Participants with acute pancreatitis. Setting: secondary setting in Spain.
Index tests	Index test: C‐reactive protein (day not stated). Further details: Technical specifications: Nephelometry (Dade Behring Marburg GmbH, Marburg, Germany). Performed by: not stated. Criteria for positive diagnosis: > 200 mg/L and > 279 mg/L.
Target condition and reference standard(s)	Target condition: pancreatic necrosis. Reference standard: CT scan.
Flow and timing	Number of indeterminates for whom the results of reference standard were available: 0 (0%). Number of participants who were excluded from the analysis: not stated.
Comparative
Notes	This study reported the diagnostic test accuracy at 2 threshold levels.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Unclear
		Unclear	Unclear
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
If a threshold was used, was it pre‐specified?	No
		High	Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	No
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
		High	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	No
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Unclear
		High