Gilmore 2010.

Study characteristics
Patient sampling	Study design: case series Data collection: retrospective image selection/prospective interpretation Period of data collection: 2003‐2008 Country: Austria Test set derived: NR. Training set: 65 melanomas and 65 dysplastic naevi, test set: 36 melanomas and 33 dysplastic naevi (included in review)
Patient characteristics and setting	Inclusion criteria: atypical melanocytic lesions with polarised dermoscopic images; describes database as a "random, but representative, cohort" but does not describe method of selection Setting: secondary (general dermatology) Prior testing: unclear Setting for prior testing: NR Exclusion criteria: none reported Sample size (participants): number included: NR Sample size (lesions): number included: 199: derivation set n = 130; test set n = 69 Participant characteristics: none reported Lesion characteristics: none reported
Index tests	Dermoscopy: no algorithm Method of diagnosis: dermoscopic images Prior test data: no further information used; described as blinded assessment Diagnostic threshold: NR; subjective impression; excise or not Diagnosis based on: single observer (n = 1) Observer qualifications: dermatologist Experience in practice: not described Experience with dermoscopy: not described; implies high or expert assessment. Conducted by 1 of the co‐authors
Target condition and reference standard(s)	Reference standard: histological diagnosis alone Details: "lesions were excised and examined microscopically by expert dermatopathologists using standard: histopathologic diagnostic criteria" Disease‐positive: 36 = test set and 65 = derivation set; disease‐negative: 33 = test set and 65 = derivation set Target condition (final diagnoses) Melanoma (in situ and invasive, or NR): 36 test set and 65 derivation set Dysplastic naevi: 33 test set and 65 derivation set
Flow and timing	Participant exclusions: none reported Index test to reference standard interval: not described
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?	Unclear
		Unclear	High
DOMAIN 2: Index Test Dermoscopy ‐ image‐based
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?	No
Were thresholds or criteria for diagnosis reported in sufficient detail to allow replication?	No
Was the test interpretation carried out by an experienced examiner?	Yes
		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