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. 2021 Dec 14;2021(12):CD012028. doi: 10.1002/14651858.CD012028.pub2

Moore 2012.

Study characteristics
Patient Sampling Type of study: retrospective
Patient characteristics and setting Sample size: 208
Females: 119
Mean age: 11.2
Inclusion criteria: paediatric patients (3 to 17 years) with suspected appendicitis
Setting: university hospital, USA, 2009 to 2011
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 follow‐up
Flow and timing Type and length of follow‐up: case note review to exclude readmission for surgery
Number of participants who were excluded from the analysis: none
Comparative  
Notes Follow‐up of case notes to look for alternative diagnosis or the absence of readmission for up to 30 days
Methodological quality
Item Authors' judgement Risk of bias Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled? Unclear    
Avoids Inappropriate Exclusion No    
Could the selection of patients have introduced bias?   High 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    
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
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