| Study characteristics |
| Patient Sampling |
The Gambia (GLCS, Gambia liver cancer study, Case‐control 2), specimens were obtained in the course of a nationwide case‐control study performed between 1997 and 2001 in three tertiary referral hospitals as described previously.
Age range and % of males not reported |
| Patient characteristics and setting |
|
| Index tests |
Serum AFP measurement.with a cut‐off value > 20 ng/mL |
| Target condition and reference standard(s) |
Differential diagnosis of HCC versus CC was established by a combination of clinical examination, imaging using ultrasonography, CT, or MRI, biochemistry (AFP and liver function enzymes testing), and histological confirmation on a small subset of patients from whom needle biopsies were available. |
| Flow and timing |
No information on interval between index test and reference standard |
| Comparative |
|
| Notes |
Grant sponsor: European Union Collaborative Project Prolifica, 7th Framework Programme, FP7‐AFRICA‐2010, Health‐F2‐2011‐265994 |
| 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? |
No |
|
|
| 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? |
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? |
|
|
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? |
No |
|
|
| Could the reference standard, its conduct, or its interpretation have introduced bias? |
|
High 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 |
|
