De Mol 2013.

Study characteristics
Patient sampling	Retrospectively, BAL fluid obtained from 456 bronchoscopies between July 2002 and June 2008 were evaluated. Paediatric patients fulfilling the host factor criteria as defined by the EORTC/MSG were included. Patients suffering from cystic fibrosis, allergic bronchopulmonary aspergillosis and other primary lung diseases were excluded. If more than one bronchoscopy was performed within a patient, the bronchoscopy done for diagnosing IPA was taken; if bronchoscopy was related in time with a CT scan, then the patient was excluded
Patient characteristics and setting	Setting: children's hospital in The Netherlands The median age of the 47 children was 9.8 years (range 1.1 to 18.2). Most were diagnosed with a haematologic disease (n = 31) of whom 2 received a HSCT
Index tests	The Platelia ELISA (Bio‐Rad Laboratories, France) was used to measure the levels of GM in serum and BAL according to the instructions of the manufacturer. An optical density index of 0.5 was considered positive All tests were performed by technicians who were unaware of the clinical condition of the patient Serum GM samples were taken twice weekly in paediatric patients considered to be at high risk of IA
Target condition and reference standard(s)	Children were classified as proven, probable or possible IPA according to the EORTC/MSG criteria (De Pauw 2008). Children with a CT scan not indicative for IPA were regarded as having no IPA
Flow and timing	No information on timing; all patients were classified by EORTC criteria; not sure if all patients were included in analyses
Comparative
No patients per category	2 proven, 17 probable, 12 possible and 16 no IA
Notes	No conflicts of interest reported
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?	Unclear
Did the study avoid inappropriate exclusions?	Unclear
		Unclear	Unclear
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
		Low	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?	Unclear
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Unclear
		Unclear