Coley 2000.

Study characteristics
Patient sampling	Prospective study
Patient characteristics and setting	Study location: USA Study period: July 1997 to August 1998 Care setting: level I paediatric trauma centre Mass casualty: no Participants enrolled: 107: 68 boys and 38 girls Participants included in analysis: 97 Age: mean age 95 months ± 51 months (range 2 to 216 months) Type of injury: blunt abdominal trauma Injury severity: GCS 12.5 ± 4.2, PTS 8.0 ± 2.8 Haemodynamic stability: stable conditions Inclusion criteria: all children suffering blunt abdominal trauma who required a CT scan for evaluation of potential injury based on the surgical team leader’s clinical judgement Exclusion criteria: haemodynamically unstable, and required immediate operative intervention
Index tests	Index test: FAST US protocol: immediately before CT scan, the in‐house on‐call paediatric radiologist performed the FAST scan and rendered a decision regarding the absence or presence and location of any free fluid. If participants had a Foley catheter placed, this was clamped as soon as possible to allow the bladder to fill, facilitating detection of free fluid in the pelvis. Hardware used: Acuson 1283 P10 system (Mountain View, CA) by using 2‐ to 5‐MHz transducers, depending on participant body habitus Description of imaging technique: 4 specified locations were evaluated: the right upper quadrant, left upper quadrant, subxyphoid region, and pelvis
Target condition and reference standard(s)	Target condition: free fluid and air Reference standard: CECT, third‐generation spiral scanner (High Speed Advantage, General Electric, Milwaukee, WI) with IV but without oral contrast (more technical specifications were not reported) Description of technique: CT scans were evaluated for the absence or presence of fluid, its location, and the presence of any visceral injury
Flow and timing	Time between US and reference standard: not reported
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
Did the study avoid inappropriate exclusions?	Yes
		Low	Low
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
If a threshold was used, was it pre‐specified?	Yes
Was the qualification of the US operator appropriate?	Yes
Was the US hardware (i.e. generation, manufacturer, probe, etc.) up to date?	Yes
Was the US protocol (i.e. 'classic' FAST) appropriate?	Yes
Are there concerns that the definition or performance of the index test (i.e. POC US of trauma) do not match generally accepted, established, or practiced rules or recommendations?	No
		Low	Low
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?	Yes
Was the qualification of the doctors (i.e. radiologists, surgeons, etc.) determining the reference standard appropriate?	Yes
Was the reference imaging standard (i.e. MDCT‐rows (4 to ≥ 256 slices), contrast‐imaging, etc.) up to date?	Unclear
Are there concerns that the definition or performance of the reference tests (e.g. CT, MRI, laparatomy, thoracotomy, autopsy, etc.) do not match generally accepted, established, or practiced rules or recommendations?	No
		Low	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
Did all participants receive a reference standard? (Risk of partial verification bias)	Yes
		Low