Kawas 2013.

Study characteristics
Patient sampling	The participants were 90 years old or older. They were participants of a longitudinal, population‐based study (90+ Study) and were invited to participate at this study. The participants had normal cognition or with either cognitive or functional impairment resulting from cognition not severe enough to meet DSM‐IV diagnostic criteria and they were classified as cognitively impaired not demented (CIND) and they agreed to postmortem brain donation. There were 5 MCI at time of performing the test planned as evaluable for efficacy participants. No further details of patient sampling and recruitment were reported.
Patient characteristics and setting	5 MCI participants diagnosed as CIND, three were considered as Aβ (+) and two were considered as Aβ (‐). The characteristics data of the participants included 13 participants: five of them were MCI participants and eight were normal controls; the mean age was 94.1 (range 90 to 99), for those considered as Aβ (+) the mean age was 94.4 (range 93 to 96) and 94.1 (range 90 to 99) years old for those with Aβ (‐). Nine of the participants were women, two of them were Aβ (+), and two of four men were Aβ (+) at baseline. APOE ϵ4 carrier: not reported MMSE: the mean MMSE was 28 (range 24 to 30); for those considered as in the Aβ (+) group, the mean was 26.5 (range 24 to 29) and 28 (range 25 to 30) for those in the Aβ (‐) group. Years of education: seven participants were reported having studied after high school: two of them were Aβ (+) and five were Aβ (‐); for those six having studied at high school or with less education, two were Aβ (+) and four were Aβ (‐), respectively. Sources of referral: not reported Setting: participants lived at home as well as in institutions in the United States of America.
Index tests	Participants were imaged using clinical PET and PET/computed tomographic scanners. Time between the 18F‐florbetapir injection and PET acquisition: fifty minutes after injection and, a 10‐min emission scan was obtained. 18F‐florbetapir administration mCi (MBq) dose: 10 mCi (370 MBq) Images were acquired with a 128 x 128 matrix (zoom x 2) and were reconstructed using iterative or row action maximization likelihood algorithms. Semiquantitative visual rating: After a training session, three nuclear medicine physicians with no access to clinical information, independently rated each PET image for amyloid burden based on successive levels of florbetapir retention from from 0 (no amyloid) to 4 (high levels of cortical amyloid). The median of the three visual scores was used to dichotomize participants into Aβ (‐) (score, 0 to 1 point) and Aβ (+) (score, 2 to 4 points).
Target condition and reference standard(s)	Target condition: any form of dementia Reference standard: DSM‐IV criteria for dementia (APA 1994)
Flow and timing	Duration of follow‐up (median): 1.5 years (all participants, including those as control normals) Number included in analysis: 5 participants; three 18F‐florbetapir (+) and two 18F‐florbetapir (‐) Progression from MCI to any form of dementia: 18F‐florbetapir (+): 2 MCI converted to any form of dementia and 1 MCI not converted to any form of dementia; 18F‐florbetapir (‐): 1 MCI converted to any form of dementia and 1 MCI not converted to any form of dementia; TP = 2; FP = 1; FN = 1; TN = 1 Loss to follow‐up: none Partial financial support from the manufacturer of 18F‐florbetapir tracer and three authors were employees
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?	Unclear
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Unclear
		Unclear	Low
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
Was the PET scan interpretation done by a trained reader physician?	Yes
Was there a clear definition of a positive result?	Unclear
		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	Unclear
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
Was the study free of commercial funding?	No
		High