Berent 1999.

Study characteristics
Patient sampling	45 participants were recruited: 18 with AD, 20 with isolated memory impairment (IMI) and 15 healthy volunteers. Sampling procedure not described. We only included data on performance of the index test to discriminate between participants with MCI who converted to dementia and those who remained stable. Exclusion criteria: no participants or control subjects were taking any centrally‐acting medications at the time of study. No further information
Patient characteristics and setting	20 participants with IMI. Participants were screened by staff of the Michigan Alzheimer’s Disease Research Center (MADRC) and classified using the clinical and psychometric IMI criteria: objective and quantitative evidence of learning inefficiency, with no evidence of impairments in general cognitive status or activities of daily living or behaviour due to change in cognition. This classification is based largely on previously published AAMI criteria (Crook 1986), although the IMI criteria do not require a formal memory complaint, and there is a liberal age restriction. Gender: 7 women; 13 men Age: mean 70.2 ± 5.5 years APOEɛ4: not reported MMSE: 26.0 ± 1.9 Education: total sample average: 15 years Sources of referral: not reported Sources of recruitment: Cognitive Disorders Clinic, Department of Neurology at the University of Michigan
Index tests	¹⁸F‐FDG PET scan ¹⁸F‐FDG PETimage sets were acquired following intravenous administration of 10 mCi (370 MBq). Image sets were analysed in quantitative and non‐quantitative (normalisation) fashions described elsewhere (Minoshima 1995). Regional glucose metabolism in frontal, temporal, parietal and occipital regions normalised to the thalamus were determined for IMI participants. Threshold: a diagnostic index based on Z‐scores of the parietal cortex was used to categorise people with IMI into normal and abnormal CMRglc (Minoshima 1995); not prespecified Index test was conducted before follow‐up.
Target condition and reference standard(s)	Target condition: conversion from MCI to Alzheimer's disease dementia Reference standard: NINCDS‐ADRDA; ICD‐10. All participants received both reference standards. Unclear whether clinicians conducting follow‐up were aware of the ¹⁸F‐FDG PET results.
Flow and timing	Duration of follow‐up: 3 years At baseline: 20 IMI; 10 IMI with positive ¹⁸F‐FDG test; 10 IMI with negative ¹⁸F‐FDG test. At follow‐up: 10 IMI with positive ¹⁸F‐FDG test: 7 IMI‐ADD; 3 IMI‐IMI; 10 IMI with negative ¹⁸F‐FDG test: 3 IMI‐ADD; 7 IMI‐IMI Number included in analysis: 20 TP = 7; FP = 3; FN = 3; TN = 7 Loss to follow‐up: none
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
		High	Low
DOMAIN 2: Index Test All tests
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?	No
		High	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
		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
		Low