Sboner 2004.

Study characteristics
Patient sampling	Study design: case series Data collection: retrospective image selection/prospective interpretation Period of data collection: NR Country: Italy (based on authors' institution)
Patient characteristics and setting	Inclusion criteria: melanocytic lesion images acquired consecutively by d‐ELM at the Department of Dermatology of Santa Chiara Hospital, Trento Setting: secondary (general dermatology) Prior testing: selected for excision (no further detail) Setting for prior testing: NR Exclusion criteria: seems that dysplastic naevi were excluded; "In this experimental setting, there were no dysplastic naevi" Sample size (participants): NR Sample size (lesions): number included: 152 Participant characteristics: none reported Lesion characteristics: mean Breslow thickness for the invasive lesions is 1.0 +/‐ 0.7 mm; 81% ≤ 1.5 mm
Index tests	Dermoscopy: no algorithm Method of diagnosis: dermoscopic images; digitial‐ELM images presented on video device Prior test data: no further information used Diagnostic threshold: NR; appears to be correct diagnosis of melanoma Diagnosis based on: single observer and average (n = 8) Observer qualifications: dermatologist Experience in practice: not described Experience with dermoscopy: not described Any other detail: the d‐ELM Image Acquisition consists of a Leica WILD M‐650 stereomicroscope (Leica Microsystem, Heerbrugg, Switzerland), with a SONY 3CCD DXC‐930P colour camera (Sony Corporation,Tokyo, Japan). The software for image acquisition was DBDERMO MIPS (Dell’Eva/Burroni Studio, Florence/Siena, Italy). The digital image size has a spatial resolution of 768 x 576 pixels and a 24‐bit colour resolution
Target condition and reference standard(s)	Reference standard: histological diagnosis alone Disease‐positive: 42; disease‐negative: 110 Target condition (final diagnoses) Melanoma (invasive): 31; melanoma (in situ): 11 Benign naevus: 110
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?	Yes
Did the study avoid inappropriate exclusions?	No
Are the included patients and chosen study setting appropriate?	No
Did the study avoid including participants with multiple lesions?	Unclear
		High	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?	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?	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