Chin 2019.

Study characteristics
Patient Sampling	Cross‐sectional, consecutive, prospective
Patient characteristics and setting	Presenting signs and symptoms: patients with suspected TB meningitis admitted to the neurology ward Age: adults, range 20 to 41 years Sex, female: not reported Children: not reported HIV infection: 18% Clinical setting: tertiary care centre (inpatient) Past history of TB: not reported Participants on anti‐TB treatment: 1 participant had received treatment Number of specimens evaluated: 11 Laboratory level: central Country: Uganda World Bank Income Classification: low High TB burden: no High TB/HIV burden: yes High MDR‐TB burden: no
Index tests	Xpert MTB/RIF and Xpert Ultra WHO SOP or manufacturer's protocol followed: no
Target condition and reference standard(s)	TB meningitis MGIT Speciation: not reported Decontamination:no
Flow and timing
Comparative
Notes	"CSF (2  ml) should be slowly pipetted directly into the Xpert Ultra cartridge. CSF should only be diluted with the manufacturer‐supplied sample reagent if less than 2  ml of CSF are available for Xpert Ultra testing." See the following article for full description of CSF processing details, Chin 2019a.
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
Could the selection of patients have introduced bias?		Low risk
Are there concerns that the included patients and setting do not match the review question?			Low concern
DOMAIN 2: Index Test (Xpert MTB/RIF)
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?	Yes
Could the conduct or interpretation of the index test have introduced bias?		Low risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			High
DOMAIN 2: Index Test (Xpert Ultra)
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?	Yes
Could the conduct or interpretation of the index test have introduced bias?		Low risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			High
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
For rifampicin resistance testing, were the reference standard results interpreted without knowledge of the results of the index test?
Could the reference standard, its conduct, or its interpretation have introduced bias?		Low risk
Are there concerns that the target condition as defined by the reference standard does not match the question?			Unclear
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
Could the patient flow have introduced bias?		Low risk