Diniz 2009.

Study characteristics
Patient Sampling	Method of sampling: selected "from sound to different degrees of non‐cavitated caries lesions" Included conditions: no cavitation and early lesions Teeth: permanent first molars Sealants: no Surface: occlusal
Patient characteristics and setting	Age: 7 to 12 years Sex: not reported Ethnicity: not reported Country: Brazil Setting: extracted teeth Number of participants/teeth/sites: 35 participants/130 teeth Prevalence: enamel 0.89, dentine 0.67
Index tests	Category of test: DIAGNOdent Sequence of test(s): index tests (visual then DIAGNOdent) followed by reference standard Examiner training and calibration: experienced and trained Teeth cleaning prior to examination: pumice slurry and water Tooth drying prior to examination: air dried Threshold applied: 0‐14 sound, 15‐21 enamel, 22+ dentine Device specifics: not reported Note: different examiners for visual, DIAGNOdent, and reference standard
Target condition and reference standard(s)	Category: radiograph and visual (third dentist), excavation where appropriate Sequence of index test and reference standard: index test then reference standard Training of examiner: experienced Blinding to index test: yes Multiple tests: combined test Site selection: teeth were drawn to aid examiners Target condition: sound, inner/outer enamel, inner/outer dentine
Flow and timing	Participants with index test but no reference standard: 0 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	Cannot extract data at the enamel threshold so no included in meta‐analysis
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	No
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Yes
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?			High
DOMAIN 2: Index Test (All)
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)?	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 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?	Yes
If a threshold was used, was it pre‐specified?	Yes
If multiple tests were applied were different examiners used for each (in vivo)?	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
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?	Yes
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
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?	Yes
Could the patient flow have introduced bias?		High risk