Kockanat 2017.

Study characteristics
Patient Sampling	Method of sampling: unclear Included conditions: non‐cavitated; "occlusal surfaces of the teeth had minimal macroscopic destruction" Teeth: primary molars Sealants: unclear Surface: occlusal
Patient characteristics and setting	Age: 9 to 12 years Sex: not reported Ethnicity: not reported Country: Turkey Setting: in vivo study conducted in dental hospital, followed by in vitro after extraction Number of participants/teeth/sites: 120 teeth (144 teeth were examined and measurements made with caries detection devices, but 120 of the 144 teeth were reported; due to inconsistencies in caries measurement results), clarification provided by study author Prevalence: enamel 0.78, dentine 0.32
Index tests	Category of test: DIAGNOdent pen and Sopro camera Sequence of test(s): visual, SoproLife, DIAGNOdent pen then CarieScan PRO Examiner training and calibration: unclear, 2 independent examiners Teeth cleaning prior to examination: plaque removed, washed without pumice Tooth drying prior to examination: air water spray, dried again for 5 seconds prior to DD Threshold applied: DIAGNOdent pen: 0‐13 sound, 14‐29 enamel, 30+ dentine Sopro camera: (0) no visible radiolucency; (1) radiolucency in the enamel; (2) radiolucency in the dentine, involving the surface or the outer third of the dentine, and (3) radiolucency in the dentine, involving the inner third of the dentine Device specifics: cylinder sapphire tip for DIAGNOdent pen, "The images were recorded to Sopro Imaging program and evaluated according to the criteria of Rechmann"
Target condition and reference standard(s)	Category: histology Sequence of index test and reference standard: index tests then reference standard Training of examiner: not reported Blinding to index test: not reported Multiple tests: no Site selection: sectioned teeth Target condition: sound, outer half of enamel, inner half of enamel, outer half of dentine, deep dentine
Flow and timing	Participants with index test but no reference standard: 24 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 used for examiner 1, with the comparison of in vivo index test versus histology Study authors contacted for clarification of study data
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?			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?	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)
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 (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?		Low 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?	No
Could the patient flow have introduced bias?		High risk