Chabanova 2011.

Study characteristics
Patient Sampling	Type of study: prospective
Patient characteristics and setting	Sample size: 48 Females: 29 Mean age: 37.1 Inclusion criteria: Clinical diagnosis of appendicitis Scheduled for appendicectomy Exclusion criteria: Pregnancy Age < 18 years Contraindications for MRI Setting: university hospital, study dates unclear
Index tests	Index test: MRI Index test criteria for positive diagnosis: see Appendix 5
Target condition and reference standard(s)	Target condition: appendicitis Reference standard: histology or operative findings
Flow and timing	Type and length of follow‐up: histology or operative findings only (no follow‐up, all participants underwent surgery) Number of participants who were excluded from the analysis: unclear
Comparative
Notes	There were applicability concerns regarding patient selection, as only patients undergoing surgery were included.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Avoids Inappropriate Exclusion	Yes
Could the selection of patients have introduced bias?		Low risk
Are there concerns that the included patients and setting do not match the review question?			High
DOMAIN 2: Index Test (All tests)
Were the index test results interpreted without knowledge of the results of the reference standard?	Unclear
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 3: Reference Standard
Are the reference standards (histo or F/U) likely to correctly classify the target condition?	Unclear
Were the reference standard (histo or F/U) results interpreted without knowledge of the results of the index test	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
Did all patients receive the same reference standard?	No
Were all patients included in the analysis?	Yes
>95% histo or F/U	Yes
all +ve MRI had surgery or F/U	Yes
all ‐ve MRI had surgery or F/U	Yes
choice of reference standard independent of MRI	No
Could the patient flow have introduced bias?		High risk