Maire 2008.

Study characteristics
Patient sampling	Type of study: retrospective study. Consecutive or random sample: unclear.
Patient characteristics and setting	Sample size: 41. Females: 27 (65.9%). Age: 64 years. Presentation: Patients with IPMN who had undergone surgical resection. Setting: secondary care, France.
Index tests	Index test: EUS‐FNA. Further details: Technical specifications: Pentax‐FG 32 UA 120°. Performed by: endoscopists. Criteria for positive diagnosis: CEA > 200 ng/mL. Second criteria for positive diagnosis: carbohydrate antigen 19‐9 > 1000 U/mL.
Target condition and reference standard(s)	Target conditions: Cancerous (invasive carcinoma) versus precancerous (dysplasia). Cancerous (high‐grade dysplasia or invasive carcinoma) versus precancerous (low‐ or intermediate‐grade 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	6 different criteria for diagnosis were used. All 6 are listed.
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	High
DOMAIN 2: Index Test Cancerous (invasive carcinoma) versus precancerous (dysplasia) ‐ EUS FNA (CEA > 200 ng/ml)
If a threshold was used, was it pre‐specified?	No
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
		High	High
DOMAIN 2: Index Test Cancerous (high grade dysplasia or invasive carcinoma) versus precancerous (low or intermediate grade dysplasia) ‐ EUS FNA (CEA > 200 ng/ml)
If a threshold was used, was it pre‐specified?	No
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
		High	High
DOMAIN 2: Index Test Cancerous (high grade dysplasia or invasive carcinoma) versus precancerous (low or intermediate grade dysplasia) ‐ EUS FNA (Ca 19.9 > 1000 U/ml)
If a threshold was used, was it pre‐specified?	No
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
		High	High
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?	Unclear
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Unclear
		Unclear