Obry‐Musset 1988.

Study characteristics
Patient Sampling	Method of sampling: unclear Included conditions: unclear Teeth: primary and permanent, premolars and molars Sealants: not reported Restorations: not reported Surface: approximal
Patient characteristics and setting	Age: 5 to 35 years Sex: not reported Ethnicity: not reported Country: France Setting: dental hospital Number of participants/teeth/sites: 330 teeth, 3960 sites (12 sites per participant) Prevalence: enamel 0.16, dentine 0.07
Index tests	Category of test: FOTI Sequence of test(s): index test prior to reference standard Examiner training and calibration: not reported Threshold applied: sound (no shadow), white or brown clinical spot (no shadow), shadow in outer dentine, shadow in inner dentine; white or brown category classed as enamel caries in our results Device specifics: Oralum lamp (Rocky Mtn, Denver), 1.2 diameter
Target condition and reference standard(s)	Category: conventional radiograph Sequence of index test and reference standard: following index test Training of examiner: not reported Blinding to index test: unclear Multiple tests: no Site selection: full surface radiographed Target condition: sound, "detectable changes, small cavity < 2 mm, large cavity > 2 mm"
Flow and timing	Participants with index test but no reference standard: 9 radiographs could not be interpreted, 14 showed orthodontic treatment Participants with reference standard but no index test: 0 Time interval between tests: minimal Participants receiving both tests but excluded from results: 0
Comparative
Notes	Only permanent surfaces used in results
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?	Unclear
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 2: Index Test (All tests)
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
If multiple tests were applied were different examiners used for each (in vivo)?
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 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	No
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
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?			High
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	No
Were all patients included in the analysis?	No
Could the patient flow have introduced bias?		High risk