Diniz 2019.

Study characteristics
Patient Sampling	Method of sampling: unclear Included conditions: unclear on severity of lesions "with varying conditions from sound to that of different stages of carious lesion" Teeth: primary molars Sealants: excluded Surface: occlusal
Patient characteristics and setting	Age: not reported Sex: not reported Ethnicity: not reported Country: Brazil Setting: extracted teeth Number of participants/teeth/sites: 88 teeth Prevalence: enamel 0.74, dentine 0.63
Index tests	Category of test: DIAGNOdent, DIAGNOdent pen, QLF (QLF Inspektor Pro; Inspektor Research System, Amsterdam, Netherlands), and Midwest Sequence of test(s): index tests (visual, DIAGNOdent, DIAGNOdent pen, QLF, and MidWest) followed by reference standard Examiner training and calibration: 1 trained and experienced examiner Teeth cleaning prior to examination: rinsed with 3in1 syringe Tooth drying prior to examination: dried for DIAGNOdent, DIAGNOdent pen and QLF; but kept moist for Midwest Threshold applied: calculated within study for DIAGNOdent, DIAGNOdent pen, and QLF DIAGNOdent: 0–4 sound, 5‐23 enamel, 24+ dentine DIAGNOdent pen: 0–3 sound, 4–19 enamel, 20+ dentine Midwest: green light/no beep ‐ sound, red light slow/moderate beep ‐ enamel, red light/fast beep ‐ 3+ dentine QLF: 0‐7.4 sound, 7.5‐13.8 enamel, 13.9+ dentine Device specifics: using Inspektor Pro Software parameter ΔF (percentage of green fluorescence radiance loss) was recorded
Target condition and reference standard(s)	Category: histology Sequence of index test and reference standard: index test then reference standard Training of examiner: not reported Blinding to index test: unclear Multiple tests: no Site selection: marked on photographs then sectioned teeth 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
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Yes
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?			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?	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?			Low concern
DOMAIN 2: Index Test (Green 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?	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?			Low concern
DOMAIN 2: Index Test (Blue fluorescence)
DOMAIN 2: Index Test (Red fluorescence)
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	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
Was there an appropriate interval between index test and reference standard?	Yes
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
Could the patient flow have introduced bias?		Low risk