Chen 2015.

Study characteristics
Patient sampling	Aim of the study: to determine the detection rate of 3‐Tesla MRI and MRI‐TBx compared to SBx Type of study: prospective cohort Selection: consecutive selection of participants who presented with a suspicion of PCa Enrolled/eligible: 420/429 Inclusion period: June 2008‐December 2013
Patient characteristics and setting	Inclusion criteria: abnormal DRE findings and/or persistently elevated PSA levels Exclusion criteria: not reported Setting: Shanghai, China. University hospital Age: median 67 years (range 45‐91) PSA: median 9.7 ng/mL (range 2.4‐35.7) Prostate volume: median 44.8 mL (range 21.2‐83.2) DRE positive: 52 participants
Index tests	Index test 1: MRI‐pathway: a 3 Tesla MRI machine (Philips Achieva) was used, with T1, T2, T2 spectral presaturation attenuated inversion recovery (SPAIR) and DWI sequences. An in‐house MRI score 1‐5 with threshold ≥ 3 for positivity were used. Cognitive transperineal MRI‐TBx were performed from all MRI‐positive lesions. Index test 2: a 10‐core fan‐shaped transperineal SBx from the peripheral zone with 2‐cores from transition zone was performed, blinded for MRI results, before taking the MRI‐TBx
Target condition and reference standard(s)	No reference standard is used in this agreement analyses study (MRI‐pathway vs SBx), therefore the reference standard domain is not applicable and disregarded.
Flow and timing	All participants underwent the same reference test Except for the 9 excluded participants (DWI artifacts due to movement of the participant) all participants were included in the analysis.
Comparative
Notes
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Did the study avoid inappropriate exclusions?	Yes
		Low	Low
DOMAIN 2: Index Test SBx
Was the MRI assessed without knowledge of the results of the (reference or other index) biopsies?	Yes
Were the MRI‐TBx performed independent of the (reference or other index) biopsies?
Was the performance of the SBx not influenced by the performance of the (reference or other index) biopsies?
		Low	High
DOMAIN 2: Index Test MRI‐pathway
Was the MRI assessed without knowledge of the results of the (reference or other index) biopsies?	Yes
Were the MRI‐TBx performed independent of the (reference or other index) biopsies?	Yes
Was the performance of the SBx not influenced by the performance of the (reference or other index) biopsies?
		Low	Low
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Was the reference standard performed independent from the index test?	Yes
		Low	Low
DOMAIN 4: Flow and Timing
Did all patients receive the same reference standard?	Yes
Were all enrolled patients included in the analysis, or were exclusions explained and not leading to a relevant bias?	Yes
		Low