Table 2.
Methodological quality evaluation of each study included in the systematic review according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS; n = 4).
| Domain | Item | Liu et al., 2020 [46] | Li et al., 2020 [44] | Yuan et al., 2020 [45] | Zhang et al., 2020 [43] | |
|---|---|---|---|---|---|---|
| Patient Selection | Signaling questions (yes/no/unclear) | Was a consecutive or random sample of patients enrolled? | No | No | No | Yes |
| Was a case–control design avoided? | Yes | Yes | Yes | Yes | ||
| Did the study avoid inappropriate exclusions? | Yes | Yes | No | Yes | ||
| Risk of bias: High/low/unclear | Could the selection of patients have introduced bias? | High | High | High | Low | |
| Concerns regarding applicability: High/low/unclear | Are there concerns that the included patients do not match the review question? | Low | Low | Low | Low | |
| Index Test | Signaling questions (yes/no/unclear) | 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 | Yes | Yes | Yes | ||
| Risk of bias: High/low/unclear | Could the conduct or interpretation of the index test have introduced bias? | Low | Low | Low | Low | |
| Concerns regarding applicability: High/low/unclear | Are there concerns that the index test, its conduct, or interpretation differ from the review question? | Low | Low | Low | Low | |
| Reference Standard | Signaling questions (yes/no/unclear) | Is the reference standard likely to correctly classify the target condition? | Yes | Yes | - | - |
| Were the reference standard results interpreted without knowledge of the results of the index test? | Unclear | Unclear | - | - | ||
| Risk of bias: High/low/unclear | Could the reference standard, its conduct, or its interpretation have introduced bias? | Low | Low | - | - | |
| Concerns regarding applicability: High/low/unclear | Are there concerns that the target condition as defined by the reference standard does not match the review question? | Low | Low | - | - | |
| Flow and Timing | Signaling questions (yes/no/unclear) | Was there an appropriate interval between index test (s) and reference standard? | Yes | Yes | - | - |
| Did all patients receive a reference standard? | Yes | Yes | - | - | ||
| Did all patients receive the same reference standard? | Yes | Yes | - | - | ||
| Were all patients included in the analysis? | Yes | Yes | - | - | ||
| Risk of bias: High/low/unclear | Could the patient flow have introduced bias? | Low | Low | - | - | |