Chopard 2009.

Study characteristics
Patient Sampling	A cohort of 106/362 patients with QD (presence of cognitive complaints+ no daily activities affected + CDR = 0,5 + no DSM‐IV criteria for dementia) who attended local memory impairment consultation centers and recruited through the database of the Regional Network for Diagnostic aids and Management of patients with cognitive impairment in the Franche‐Comtê geographical area was included Exclusion criteria: craniocerebral trauma, stroke within 3 months from the beginning of the study, acute neurological or somatic pathologies, progressive psychiatric illness except major depression
Patient characteristics and setting	A cohort of 106 participants were followed‐up for 6 to 24 months (mean = 14.9 ± 4.5), from an original sample of 362 patients with QD (59% without follow‐up) Demographic data reported by total sample and by conversion at follow‐up (Tables 1 and 2): Gender: 41.5% M, 58.5% F Age: 75.7 ± 5.0 years APOE 4 carrier: not reported Education more than 12 years = 8.5% MMSE at baseline: 25.2 ± 2.7 Sources of referral: the database of the Regional Network for Diagnostic aids and Management of patients with cognitive impairment in the Franche‐Comtê geographical area Sources of recruitment: the database of the Regional Network for Diagnostic aids and Management of patients with cognitive impairment in the Franche‐Comtê geographical area
Index tests	Mini‐Mental state Examination (MMSE): no details about version and scoring systems are provided. It is unclear if threshold was pre‐specified or not (26/27) and who administered and interpreted the test
Target condition and reference standard(s)	Target condition:Conversion from MCI to Dementia and later defined as ADD, VaD, DLB or FTD Reference standard: dementia was defined according with the following criteria: progressive worsening of cognitive function at follow‐up severe enough to affect IADLs and progression of CDR score form 0.5 to 1. Standard criteria were used for diagnosis of ADD (NINCDS‐ADRDA), vascular dementia (NINDS‐AIREN), dementia for LB (McKeith criteria) and frontotemporal dementia (Lund and Manchester criteria). Dementia was defined independently of MMSE scores
Flow and timing	Duration of follow‐up: 6 to 24 months (mean 14.9± 4.5 months) At baseline: 106 patients with QD At follow‐up: 38 converted to dementia; 68 remained free of dementia TP = 29; FP = 41; FN = 9; TN = 27 Sensitivity: 76%; Specificity: 40% (calculated in RevMan5); cut‐off: ≤ 26 (26/27) (page 705) Loss to follow‐up: none
Comparative
Notes
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?	Yes
Did the study avoid inappropriate exclusions?	Yes
Could the selection of patients have introduced bias?		Unclear risk
Are there concerns that the included patients and setting do not match the review question?			Low concern
DOMAIN 3: Reference Standard
Is the assessment used for clinical diagnosis of dementia acceptable?	Yes
Was clinical assessment for dementia performed without knowledge of the MMSE results?	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 MMSE and the reference standard?	Yes
Did all participants receive the same reference standard?	Yes
Were all participants included in the final analysis?	Yes
Could the patient flow have introduced bias?		Low risk