Menzies 1996.

Study characteristics
Patient sampling	Study design: unclear. Abstract describes including a random sample of excised lesions from a larger database Data collection: retrospective image selection/prospective interpretation Period of data collection: NR Country: Australia Test set derived: NR; describes 'division' into a training set and a test set
Patient characteristics and setting	Inclusion criteria: PSLs from the Sydney Melanoma Unit with dermoscopic images and histological diagnoses; melanomas and randomly selected clinically atypical non‐melanoma lesions were included Setting: specialist unit (skin cancer/PLC) Prior testing: selected for excision Setting for prior testing: specialist unit (skin cancer/PLC) Exclusion criteria: unequivocal non‐melanoma excluded Sample size (participants): number included: NR Sample size (lesions): number included: 385 Participant characteristics: none reported Lesion characteristics: none reported
Index tests	Dermoscopy: Menzies criteria Method of diagnosis: dermoscopic images Prior test data: no further information used Diagnostic threshold: presence of 2 negative features and at least 1 positive feature. Negative features: point and axial symmetry of pigmentation or presence of only a single colour. Positive features of melanoma: multiple (5‐6) colours; blue‐white veil; multiple brown dots; multiple blue/grey; peripheral black dots or globules; a broadened network; pseudopods; radial streaming; scar‐like Diagnosis based on: unclear (n = NR) Observer qualifications: NR; likely dermatologists Experience in practice: not described Experience with dermoscopy: not described
Target condition and reference standard(s)	Reference standard: histological diagnosis alone (not further described) Disease‐positive: 107; disease‐negative: 278 Target condition (final diagnoses) Melanoma (invasive): 107; BCC: 18 Ephelis/lentigo 17; SK: 23; benign acquired naevi ‐ 58; dysplastic naevi ‐ 105; blue naevi 11; SN 6; spindle cell naevus 2; DF 2; hemangioma 13; solar keratosis 9; other 14
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?	Yes
Was a case‐control design avoided?	Unclear
Did the study avoid inappropriate exclusions?	Yes
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?	Yes
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?	Yes
Was the test interpretation carried out by an experienced examiner?	Unclear
		Low	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?	Unclear
		Low	Unclear
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