A. DETAILS
Describe the reference standard and how it was conducted and interpreted (cut and paste from paper if possible)
Operator characteristics (e.g. training)
Thresholds/Criteria used to define positive and negative tests for target condition, if provided
B. ASSESSMENT RISK OF BIAS
Is the reference standard likely to correctly classify the target condition?	o “Yes” if the reference standard used in the paper matches those chosen in this protocol (DSM criteria applied by a expert) o “No” if the above criteria is not met. o “Unclear” if insufficient information is presented.
Were the reference standard results interpreted without knowledge of the results of the index test?	o “Yes” if the paper states that the reference test is interpreted by clinicians/researchers who had not seen the reference standard results. o “No” if the result(s) of the CAM‐ICU were known to the individual performing the DSM criteria. o “Unclear” if there is insufficient information to make a judgment about this issue.
Could the reference standard, its conduct, or its interpretation have introduced bias?	o “High” if a subset of reference standard tests were conducted or interpreted in a different manner, or under different conditions. o “Low” if it is clear that the conduct and interpretation of all reference standard tests were appropriate and could not have introduced bias. o “Unclear” if there is insufficient information presented to assess the potential of conduct and interpretation of the reference standard test to introduce bias.
C. CONCERNS ABOUT APLICABILITY
Are there concerns that the target condition as defined by the reference standard does not match the review question?	o “High” if the target condition is not delirium or it is not clearly stated. o “Low” if it is clearly stated that the target condition is delirium. o “Unclear” if there is insufficient information presented to assess potential concerns about the target condition.