| Study characteristics |
| Patient Sampling |
Serum samples were obtained from sixty patients with chronic liver disease, divided into two groups: Group (I) included 40 patients with HCC. Patients with cancers other than HCC or metastatic liver cancer were excluded. Group (II) included 20 patients with liver cirrhosis and without any evidence of HCC, and Group (III) included 20 healthy adults recruited as controls.
Age range: 48‐89. Males 77.5% |
| Patient characteristics and setting |
|
| Index tests |
Serum AFP and osteopontin levels were determined using an enzyme‐linked binding protein assay kit. AFP was assayed by an enzyme immunoassay (EIA) Kit (Roche Mannheim, Germany). |
| Target condition and reference standard(s) |
HCC was diagnosed by abdominal US and confirmed by triphasic CT scan. AFP was assayed by an enzyme immunoassay (EIA) Kit (Roche Mannheim, Germany). |
| Flow and timing |
No information on interval between index test and reference standard |
| Comparative |
|
| Notes |
Authors declared no conflicts of interest. |
| Methodological quality |
| Item |
Authors' judgement |
Risk of bias |
Applicability concerns |
| DOMAIN 1: Patient Selection |
| Was a consecutive or random sample of patients enrolled? |
No |
|
|
| Was a case‐control design avoided? |
No |
|
|
| Did the study avoid inappropriate exclusions? |
Unclear |
|
|
| Could the selection of patients have introduced bias? |
|
High risk |
|
| Are there concerns that the included patients and setting do not match the review question? |
|
|
High |
| DOMAIN 2: Index Test (AFP) |
| 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? |
No |
|
|
| Could the conduct or interpretation of the index test have introduced bias? |
|
High risk |
|
| Are there concerns that the index test, its conduct, or interpretation differ from the review question? |
|
|
Low concern |
| DOMAIN 2: Index Test (US+AFP) |
| DOMAIN 2: Index Test (US) |
| 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 |
|
|
| 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? |
|
|
Low concern |
| DOMAIN 4: Flow and Timing |
| Was there an appropriate interval between index test and reference standard? |
Unclear |
|
|
| Did all patients receive the same reference standard? |
No |
|
|
| Were all patients included in the analysis? |
Yes |
|
|
| Could the patient flow have introduced bias? |
|
High risk |
|
