Rau 1998.

Study characteristics
Patient sampling	Type of study: prospective study. Consecutive or random sample: unclear.
Patient characteristics and setting	Sample size: 70. Females: 31 (44.3%). Age: 49 years. Presentation: Participants with acute pancreatitis (within fewer than 4 days of onset of symptoms). Setting: secondary care setting, Germany.
Index tests	Index test: C‐reactive protein (day 3). Further details: Technical specifications: laser nephelometry. Performed by: not stated. Criteria for positive diagnosis: > 140 mg/L. Index test: lactate dehydrogenase (day 5). Further details: Technical specifications: enzyme kinetic method. Performed by: not stated. Criteria for positive diagnosis: > 290 U/L.
Target condition and reference standard(s)	Target condition: pancreatic necrosis. Reference standard: CT scan or intra‐operative findings, or both. Further details: Technical specifications: CT scan: CT 9800 (General Electric) and CT Twin Flash (Elscint); Surgery: not applicable. Performed by: not stated. Criteria for positive diagnosis: not stated.
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 2 index tests. Authors provided additional information that the index tests were interpreted without knowledge of reference standards. The authors also stated that the interval between the index tests and CT scan was 2 to 6 days, and the interval between index tests and laparotomy was 18 days.
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?	Yes
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?	Yes
Did all patients receive the same reference standard?	No
Were all patients included in the analysis?	Unclear
		High

CT: computed tomography