Dillman 2016.
| Study characteristics | |||
| Patient Sampling | Type of study: retrospective | ||
| Patient characteristics and setting | Sample size: 103 Females: 56 Mean age: 11.5 Inclusion criteria: paediatric patients (< 18 years) with suspected appendicitis and equivocal ultrasound Exclusion criteria: MRI scan not completed Setting: university hospital, USA, 2013 to 2014 |
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| Index tests | Index test: MRI Index test criteria for positive diagnosis: see Appendix 5 |
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| Target condition and reference standard(s) | Target condition: appendicitis Reference standard: histology or follow‐up |
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| Flow and timing | Type and length of follow‐up: case note review to exclude readmission within 30 days Number of participants who were excluded from the analysis: 3 |
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| 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? | Yes | ||
| Avoids Inappropriate Exclusion | 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? | Unclear | ||
| Could the conduct or interpretation of the index test have introduced bias? | Unclear risk | ||
| Are there concerns that the index test, its conduct, or interpretation differ from the review question? | High | ||
| DOMAIN 3: Reference Standard | |||
| Are the reference standards (histo or F/U) likely to correctly classify the target condition? | Yes | ||
| Were the reference standard (histo or F/U) results interpreted without knowledge of the results of the index test | Unclear | ||
| Could the reference standard, its conduct, or its interpretation have introduced bias? | Unclear 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? | Yes | ||
| Were all patients included in the analysis? | Yes | ||
| >95% histo or F/U | No | ||
| all +ve MRI had surgery or F/U | Yes | ||
| all ‐ve MRI had surgery or F/U | No | ||
| choice of reference standard independent of MRI | No | ||
| Could the patient flow have introduced bias? | High risk | ||