Chan 2001.

Clinical features and settings	Hospital setting (University of Malaya Medical Center, Malaysia) Clinical features for study inclusion: fever > 37.5 °C with respiratory symptoms and chest signs or chest radiograph changes compatible with a diagnosis of pneumonia
Participants	Children aged 1 month to 15 years with community‐acquired pneumonia Number of participants: 170 Male participants: 112, (65.9%) Number of participants with M. pneumoniae: 40 (23.5%)
Study design	Prospective observational cohort study
Target condition and reference standard(s)	M. pneumoniae detected based on serological testing of acute and convalescent blood samples taken 2 to 4 weeks apart (passive particle agglutination test). Presence of M. pneumoniae infection defined as single antibody titre of more than 1:160 or a fourfold or greater rise in antibody titre between acute and convalescent samples. The antibody titre threshold used to diagnose M. pneumoniae on a single serum sample was adjusted from 1:40 (manufacturer's recommendation) to 1:160. A titre of 1:40 was considered too low, as this was found in 45% of healthy blood donors. However, a titre of 1:160 was only found in 10% of the healthy population
Index and comparator tests	Wheeze
Follow‐up	Children followed up during admission. Duration between admission and recording of clinical features/initial sample taking was not reported
Notes	Extra‐pulmonary complications were encountered in 3 children with M. pneumoniae. Two children had elevated liver enzymes which normalised after a week and one died from multi‐organ failure on day 15 of illness
Table of Methodological Quality
Item	Authors' judgement	Description
Representative spectrum? All tests	Unclear	Co‐morbidities in study population were not reported. Did not state whether or not children with co‐morbidities were excluded
Acceptable reference standard? All tests	Yes	M. pneumoniae detected based on serological testing of acute and convalescent blood samples taken 2 to 4 weeks apart
Acceptable delay between tests? All tests	Unclear	Timing of collection of acute blood sample in relation to recording of clinical features was not reported
Partial verification avoided? All tests	Yes	All study participants were subjected to the same laboratory tests
Differential verification avoided? All tests	Yes	All study participants were subjected to the same laboratory tests
Incorporation avoided? All tests	Yes	Clear thresholds for positive serological diagnosis of M. pneumoniae reported
Reference standard results blinded? All tests	Yes	Clinical symptoms and signs were recorded during the acute community‐acquired pneumonia illness episode, when the results of convalescent serum samples would not have been available
Index test results blinded? All tests	Yes	Clear thresholds for positive serological diagnosis of M. pneumoniae reported
Relevant clinical information? All tests	Yes	Baseline data were collected from participants on age, sex, ethnicity and duration of illness
Uninterpretable results reported? All tests	No	No intermediate or borderline serology results reported. Study did not provide definition of intermediate or borderline serology result
Withdrawals explained? All tests	Yes	Data reported for all 170 participants; no withdrawals