Muthuveloe 2016.

Study characteristics
Patient sampling	Aim of the study: to assess the detection rate of significant PCa by transperineal template‐guided Bx Type of study: partial prospective and retrospective analysis Selection: all men who received MRI prior to template Bx were selected, no criteria reported for performing MRI or template Bx Enrolled/eligible: 200/unclear (9 Bx‐naïve‐, 162 prior‐negative Bx and 29 active surveillance participants). Inclusion period: March 2013‐December 2014
Patient characteristics and setting	Inclusion criteria: transperineal template‐guided PBx and MRI prior to Bx Exclusion criteria: previous brachytherapy, previous template biopsies for anorectal abnormalities Setting: Birmingham, UK. Tertiary referral centre Age*: median (range) 68 years (46‐81); 65 (47‐78) PSA*: median (range) 11.5 ng/mL (1.2‐92.5); 10 (2.7‐61). Prostate volume: not reported *reported for template Bx positive (n = 71) and template Bx negative (n = 103) participants, respectively
Index tests	Index test: MRI only, assessed prior to template Bx. No details for MRI‐acquisition are reported. The PI‐RADS version 1 was used with a 1‐5 score and threshold ≥ 3 for positivity.
Target condition and reference standard(s)	Target condition: GS ≥ 3+3, GS ≥ 3+4 and GS ≥ 4+3 Reference standard: a minimum of 24 sector transperineal prostatic Bx cores were taken in a systematic fashion using a 5 mm brachytherapy template grid, prostate volume depended. Blinding for MRI results was not reported.
Flow and timing	All participants underwent the same reference test and were included in the analysis.
Comparative
Notes	Study authors provided additional data. We excluded the 29 active surveillance or other indication participants from this current analysis. The remaining 9 Bx‐naïve‐ and 162 prior‐negative participants were included.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Did the study avoid inappropriate exclusions?	Yes
		Unclear	Low
DOMAIN 2: Index Test MRI
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	Unclear
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?	Unclear
		Unclear	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