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. 2021 Apr 15;2021(4):CD013346. doi: 10.1002/14651858.CD013346.pub2

Khairy 2015.

Study characteristics
Patient Sampling Serum levels of AFP and AFP‐L3 were determined in 47 patients with HCC and 17 patients with liver cirrhosis admitted to Kasr Al‐Aini Hospital Cairo University.
Age range and % of males not reported.
Patient characteristics and setting  
Index tests AFP was assessed by ELISA technique in all patients. No pre‐defined cut‐off
Target condition and reference standard(s) HCC: all HCC patients were diagnosed by non‐invasive criteria applied to cirrhotic patients according to the 2012 European Association for the Study of the Liver (EASL) guidelines.
Flow and timing No data on interval between index test and reference standard
Comparative  
Notes No data on 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? Unclear    
Was a case‐control design avoided? No    
Did the study avoid inappropriate exclusions? Yes    
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? No    
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