Thompson 2016.

Study characteristics
Patient sampling	Aim of the study: to assess the accuracy of mpMRI for significant PCa detection before diagnostic Bx in men with an abnormal PSA/DRE Type of study: prospective cohort Selection: consecutive Enrolled/eligible: 344/388 (44 participants were excluded due to refusing informed consent, MRI or Bx) Inclusion period: April 2012‐March 2014
Patient characteristics and setting	Inclusion criteria: men > 40 years, scheduled to undergo Bx for abnormal PSA or DRE, with a life expectancy > 10 years and no previous prostate MRI or Bx Exclusion criteria: none Setting: Sydney, Australia, University hospital Age: median 62.9 years (IQR 55.9‐67.1) PSA: median 5.2 ng/mL (IQR 3.7‐7.1) Prostate volume: median 40 mL (IQR 30‐54)
Index tests	Index test: MRI only. A 1.5 and 3 Tesla MRI (vendor unknown) was used in 2 centres. PI‐RADS version 1 was used, with score ≥ 3 considered positive. MRI was reported before the Bx procedure. Cognitive‐fusion transperineal MRI‐TBx were performed, independent of the reference test. However, the MRI‐TBx results are not reported separately from template Bx results. Therefore the MRI‐TBx could not be assessed as an index test.
Target condition and reference standard(s)	Target condition: GS ≥ 3+3, GS ≥ 3+4 and GS ≥ 4+3 Reference standard: transperineal mapping biopsies (median 30 cores, using a brachytherapy grid, with relative periurethral zone sparing) from 18 template locations. MRI outcomes were known at time of Bx. MRI‐TBx were taken in addition to the TTMB and could not be disaggregated from the TTMB results and were therefore included in the reference standard results.
Flow and timing	All participants underwent same TTMB technique. 44 participants were excluded: 16 refused consent, 8 refused MRI and 10 refused Bx
Comparative
Notes	Study authors provided additional information
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 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	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?	No
		High	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?	No
		High