de Jong 2012.

Study characteristics
Patient sampling	Type of study: prospective study. Consecutive or random sample: consecutive patients.
Patient characteristics and setting	Sample size: 32. Females: 19 (59.4%). Age: 62 years. Presentation: Inclusion criteria Patients above 18 years of age with a pancreatic cystic lesion of unknown aetiology detected on cross‐sectional imaging (transabdominal ultrasound, CT, MRI). Patients undergoing surgical resection. Exclusion criteria Patients with a recent episode of acute pancreatitis or with known chronic pancreatitis. Clotting disorders. Acute pancreatitis or a synchronic malignancy elsewhere in the body. Setting: secondary care, Netherlands.
Index tests	Index test: EUS. Further details: Technical specifications: Olympus GF‐UC(T)140(P). Performed by: endoscopists. Criteria for positive diagnosis: diffuse main duct dilatation (> 10 mm), and/or mural nodes were present, and/or a solid component was seen outside the cyst. Index test: MRI. Further details: Technical specifications: Avanto 1.5 Tesla MR. Performed by: radiologist. Criteria for positive diagnosis: diffuse main duct dilatation (> 10 mm), and/or mural nodes were present, and/or a solid component was seen outside the cyst.
Target condition and reference standard(s)	Target condition: cancerous (invasive carcinoma) versus precancerous (dysplasia). Reference standard: surgical excision. Further details: Technical specifications: not applicable. Performed by: clinicians. 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: not stated.
Comparative
Notes	Interval between index test and reference standard varied, with a median of 78 days.
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	High
DOMAIN 2: Index Test Cancerous (invasive carcinoma) versus precancerous (dysplasia) ‐ EUS
If a threshold was used, was it pre‐specified?	Yes
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
		Unclear	Low
DOMAIN 2: Index Test Cancerous (invasive carcinoma) versus precancerous (dysplasia) ‐ MRI
If a threshold was used, was it pre‐specified?	Yes
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
		Unclear	Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
		Unclear	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?	No
		High