Huth 2008.

Study characteristics
Patient Sampling	Method of sampling: randomised Included conditions: no cavitation and early lesions Teeth: permanent molars Sealants: no Surface: occlusal
Patient characteristics and setting	Age: not reported Sex: not reported Ethnicity: not reported Country: Switzerland Setting: dental hospital Number of participants/teeth/sites: 120 participants Prevalence: not reported
Index tests	Category of test: DIAGNOdent pen Sequence of test(s): index tests (visual, radiograph, DIAGNOdent pen) performed prior to reference standard Examiner training and calibration: unclear, completed by a dental professional Teeth cleaning prior to examination: yes Tooth drying prior to examination: yes Threshold applied: calculated in study, multiple thresholds investigated within study Device specifics: not reported
Target condition and reference standard(s)	Category: excavation or visual/radiograph with follow‐up Sequence of index test and reference standard: index test then reference standard Training of examiner: experienced Blinding to index test: unclear Multiple tests: yes Site selection: unclear which site was investigated with which test Target condition: sound, enamel, dentinal lesions
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	Data not useable as reported the mean for DIAGNOdent readings
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?	Yes
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?	Yes
If a threshold was used, was it pre‐specified?	No
If multiple tests were applied were different examiners used for each (in vivo)?	Unclear
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)
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?	No
If multiple tests were applied were different examiners used for each (in vivo)?	Unclear
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 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