Palmqvist 2012.

Study characteristics
Patient Sampling	A MCI cohort of 133 MCI patients referred to the clinic between 2000 to 2006 were assessed. Most patients were referred from primary care units, but some referrals came from other clinics at the hospital. No further details about recruitment were reported Exclusion criteria: patients with diagnosis of haematoma, brain tumour, CNS infection, schizophrenia, major depressive episode or current alcohol abuse were not included
Patient characteristics and setting	A total of 133 participants with MCI, diagnosed with the Petersen 2004 criteria, were recruited in the memory clinic. Baseline demographic data reported in table 1 (p4) Gender: MCI‐MCI: 34 F, 28 M; MCI‐AD: 36 F, 16 M; MCI‐other dementias: 8 F, 11 M Age: MCI‐MCI: 69.8 years (55 to 85); MCI‐AD: 75.3 years (55 to 87); MCI‐other dementias: 71.2 years (59 to 83) APOE4 carrier: MCI‐MCI: 28; MCI‐AD: 39; MCI‐other dementias: 12 MMSE: MCI‐MCI: mean 28.1 ± 1.2; MCI‐AD: mean 26.1 ± 1.5; MCI‐other dementias: mean 27.1 ± 2.0 MMSE (O & R): MCI‐MCI: mean 11.4 ± 1.1; MCI‐AD: mean 9.6 ± 1.4; MCI‐other dementias: mean 10.9 ± 1.3 Education: not reported Sources of referral: most patients were referred from primary care units, but some referrals came from other clinics at the hospital Sources of recruitment: memory clinic of Skane University Hospital, Malmö, Sweden
Index tests	Mini‐Mental state Examination (MMSE): Full details provided. The test was administered by physicians experienced in dementia disorders. also, the items about orientation and recall (MMSE O&R) are assessed. Used thresholds were not pre‐specified
Target condition and reference standard(s)	Target condition: conversion from MCI to Alzheimer's disease dementia, vascular dementia, dementia with Lewy bodies Reference standard: AD:NINCDS‐ADRDA criteria, Vascular dementia (VaD); either probable VaD according to NINDS‐AIREN (Roman 1993) or subcortical VaD according to Erkinjuntti 2000, Dementia with Lewy bodies (DLB): according to the McKeith 2005 criteria A consensus group of three study physicians experienced in dementia disorders (OH, JH and LM) later determined all diagnoses. The physicians were blinded to the CSF and cognitive test data collected on the initial visit
Flow and timing	Duration of follow‐up: mean 5.9 years (range 3.2 to 8.8 years) At baseline: 133 MCI At follow up: 71 MCI converters (52 MCI‐AD; 10 MCI‐VD; 4 MCI‐DLB; 3 MCI‐PSP; 1 MCI‐SD; 1 MCI‐dementia due to brain tumour); 62 MCI stable Table 2: ROC curve analysis: predicting follow‐up AD diagnosis 1) MMSE (cut‐off ˂ 27): sensitivity = 62%; specificity = 84% Conversion to AD dementia: N = 133: 52 AD (‘disease positive’) and 81 ‘disease negative’ (non‐AD) TP = 32; FP = 13; FN = 20; TN = 68 (calculated in Revman5) 2) MMSE (O & R) (cut‐off ˂ 10): sensitivity = 54%; specificity = 94% Conversion to AD dementia: N = 133: 52 AD (‘disease positive’) and 81 ‘disease negative’ (non‐AD) TP = 28; FP = 5; FN = 24; TN = 78 (calculated in RevMan 5)
Comparative
Notes	The trial investigators contacted; they confirmed that there was no overlapping between samples in two papers, Palmquist 2012 and Buchhave 2008. E‐mail from Dr Palmqvist on 28 February 2014
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