Ndetei 1983.

Study characteristics
Patient sampling	Prospecitve, consecutive.
Patient characteristics and setting	N included in study: 82. N in analysis: 80. Age: Not reported. Gender: M 38, F 42. Ethnicity: African. Comorbid disorders: Not reported. Duration of symptoms: Not reported. Concurrent medications used: Not reported. Inclusion criteria: All the recent “first ever admissions” to the professorial acute wards of Mathare Hospital in Nairobi (The National Psychiatric referral and teaching hospital) between the ages of 15‐ 65 years. In hospital between 7 days and 4 weeks. Exclusion criteria: Psychiatric illness complicated by a physical condition. Study aim: To ascertain the prevalence and frequency of FRS in Kenyan schizophrenic patients diagnosed using an objective schizophrenic screening index ‐ the New Haven Schizophrenic Index (NHSI), which does not include FRS in the diagnostic criteria for schizophrenia. Previous treatment for schizophrenia: Not reported. Clinical setting: Inpatients. Country: Kenya.
Index tests	Description of FRS used: FRS measured using the PSE. At least one FRS needed to be present. Professionals performing test: Not reported. Resolution of discrepancies: Not reported. How FRS used in study: Prevalence.
Target condition and reference standard(s)	Reference standard: The New Haven Schizophrenic Index. Target condition(s): Schizophrenia. Professionals performing test: Not reported. Resolution of discrepancies: Not reported.
Flow and timing	Study process: Patients were screened using the New Haven Schizophrenic Index. Before deciding whether the patient met the criteria for a diagnosis of schizophrenia each patient was then given a structured pre‐coded interview on their social‐demographic characteristics, followed by the Present State Examination (PSE) to measure FRS. Each symptom was rated as present only when the interviewer was convinced that any possible cultural interpretation or misunderstanding of the question had been excluded. The reference standard and index tests were applied in the same interview. Follow‐up: Not reported. Exclusions: Two patients were excluded from the analysis, because the interviews were not considered adequate and reliable.
Comparative
Notes	New Haven Schizophrenia Index used as it does not contain FRS. "It must, however, be pointed out that some or all of the NHSI negative patients in this study could have been regarded as schizophrenic by other diagnostic criteria"
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?	Yes
		Low	Low
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
Did the study pre‐specify whether they were using one or multiple FRSs?	Yes
		Low	High
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Unclear
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
		Unclear	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Were all patients included in the analysis?	No
Did all patients receive a reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Did all patients receive an index test?	Yes
Did all patients receive the same index test?	Yes
		Low