Anttonen 2003.

Study characteristics
Patient Sampling	Method of sampling: consecutive Included conditions: no cavitation and enamel lesions Teeth: primary molars and premolars Sealants: yes Surface: occlusal
Patient characteristics and setting	Age: 7 to 8 years Sex: not reported Ethnicity: not reported Country: Finland Setting: public dental clinics Number of participants/teeth/sites: 55 participants/650 teeth Prevalence: not reported
Index tests	Category of test: DIAGNOdent Sequence of test(s): visual then DIAGNOdent, then drilling and radiographs Examiner training and calibration:yes Teeth cleaning prior to examination: not reported Tooth drying prior to examination: air syringe Threshold applied: at intervals of 10 from 0‐100 Device specifics: tip not reported
Target condition and reference standard(s)	Category: combined test of: visual, drill, radiograph Sequence of index test and reference standard: visual element completed before DIAGNOdent Training of examiner: not reported Blinding to index test: no Multiple tests: yes Site selection: not clearly reported Target condition: sound, inactive enamel, active enamel, dentinal
Flow and timing	Participants with index test but no reference standard: unclear Participants with reference standard but no index test: unclear Time interval between tests: minimal Participants receiving both tests but excluded from results: unclear
Comparative
Notes	Unclear reporting of data. Primary teeth had visual and DIAGNOdent only. Permanent had excavation and radiograph, but unclear on numbers of who receiving tests
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	No
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?			Low concern
DOMAIN 2: Index Test (All)
Were the index test results interpreted without knowledge of the results of the reference standard?	No
If a threshold was used, was it pre‐specified?	No
If multiple tests were applied were different examiners used for each (in vivo)?	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?			High
DOMAIN 2: Index Test (Green fluorescence)
DOMAIN 2: Index Test (Blue fluorescence)
DOMAIN 2: Index Test (Red fluorescence)
Were the index test results interpreted without knowledge of the results of the reference standard?	No
If a threshold was used, was it pre‐specified?	No
If multiple tests were applied were different examiners used for each (in vivo)?	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?			High
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?	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?			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?	Unclear
Could the patient flow have introduced bias?		High risk