Krahn 1998.

Study characteristics
Patient sampling	Study design: CS Data collection: prospective Period of data collection: NR Country: Germany
Patient characteristics and setting	Inclusion criteria: excised PSLs Setting: secondary (general dermatology) Prior testing: NR Setting for prior testing: NR Exclusion criteria: none reported Sample size (participants): number included: 80 Sample size (lesions): number included: 80 Participant characteristics: none reported Lesion characteristics range in thickness (melanomas) 0.18‐1.9 mm; 29/39 < 0.76 mm; 7/39 0.76‐1.5 mm; 3/39 > 1.5 mm
Index tests	VI: no algorithm reported Method of diagnosis: in‐person diagnosis Prior test data: unclear Other test data: dermoscopy undertaken by same clinician(s) subsequent to clinical evaluation Diagnostic threshold: NR; no details Diagnosis based on: single observer (n = 1) Observer qualifications: NR, likely dermatologist Experience in practice: not described Experience with index test: not described Dermoscopy: evaluated in same study; no algorithm
Target condition and reference standard(s)	Reference standard: histological diagnosis alone including histometrics Disease positive: 39; disease negative: 41 Target condition (final diagnoses) Melanoma (invasive): 39 (SSM, lentigo MM, nodular M) Benign naevus: 37 common naevus; 3 dysplastic nevus, 1 Spitz naevus
Flow and timing	Excluded participants: none reported Time interval to reference test: NR Time interval between index test(s): NR
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
Are the included patients and chosen study setting appropriate?	No
Did the study avoid including participants with multiple lesions?	Yes
		Unclear	High
DOMAIN 2: Index Test Visual Inspection ‐ in‐person
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?	Unclear
For studies reporting the accuracy of multiple diagnostic thresholds, was each threshold or algorithm interpreted without knowledge of the results of the others?
Was the test applied and interpreted in a clinically applicable manner?	Yes
Were thresholds or criteria for diagnosis reported in sufficient detail to allow replication?	No
Was the test interpretation carried out by an experienced examiner?	Unclear
		Unclear	High
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
Expert opinion (with no histological confirmation) was not used as a reference standard	Yes
Was histology interpretation carried out by an experienced histopathologist or by a dermatopathologist?	Yes
		Low	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?	Yes
If the reference standard includes clinical follow‐up of borderline/benign appearing lesions, was there a minimum follow‐up following application of index test(s) of at least: 3 months for melanoma or cSCC or 6 months for BCC?
If more than one algorithm was evaluated for the same test, was the interval between application of the different algorithms 1 month or less?
		Unclear