Alsebaey 2016.

Study characteristics
Patient Sampling	Eighty‐seven people were enrolled into the study. Twenty‐two healthy people as a control group (n = 22), 22 patients in the cirrhosis group and finally 43 patients in the HCC group. The diagnosis of cirrhosis was based on clinical, laboratory, and ultrasonography findings (Schuppan and Afdhal, 2008). HCC was diagnosed according to the EASL guideline (European Association for the Study of the et al.). Exclusion criteria were sepsis, GIT bleeding, concurrent medical disease such as long standing diabetes mellitus, chest or cardiac disease. Age range and % of males not reported
Patient characteristics and setting
Index tests	AFP no specification
Target condition and reference standard(s)	HCC CT and EASL criteria; controls ultrasound
Flow and timing	No information on interval between index test and reference standard
Comparative
Notes	No information on conflicts of interest or funding
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?	Unclear
Were all patients included in the analysis?	No
Could the patient flow have introduced bias?		High risk