Mendes 2012.

Study characteristics
Patient Sampling	Method of sampling: selected Included conditions: non‐cavitated and enamel lesions Teeth: primary molars Sealants: unclear Surface: occlusal and approximal
Patient characteristics and setting	Age: 4 to 12 years, mean 7.3 Sex: occlusal ‐ 30 male, 38 female; approximal ‐ 53 male, 73 female Ethnicity: not reported Country: Brazil Setting: dental hospital Number of participants/teeth/sites: occlusal ‐ 68 participants/407 sites; proximal ‐ 132 participants/1213 sites Prevalence: occlusal ‐ dentine 0.05; proximal ‐ 0.04
Index tests	Category of test: DIAGNOdent Sequence of test(s): visual, then radiograph, then DIAGNOdent Examiner training and calibration: not reported Teeth cleaning prior to examination: brush, pumice and slurry Tooth drying prior to examination: 5 seconds Threshold applied: occlusal: > 34 dentine; approximal: > 16 Device specifics: tip 2 was used for occlusal surfaces; tip 1 was used for approximal surfaces
Target condition and reference standard(s)	Category: occlusal ‐ excavation of those teeth suspected of dentinal caries (ICDAS score of 6 3), the remainder received visual assessment only approximal ‐ "temporary separation using orthodontic rubber rings placed around the contact points for 7 days. Two examiners evaluated each surface for the presence of cavities" Sequence of index test and reference standard: index test then reference standard Training of examiner: not reported Blinding to index test: not reported Multiple tests: yes Site selection: photographed and site selected Target condition: cavitated caries lesions; "the cut‐off point for visual inspection was an ICDAS score of 3"
Flow and timing	Participants with index test but no reference standard: occlusal: unclear, approximal: 6 Participants with reference standard but no index test: 0 Time interval between tests: occlusal ‐ unclear, approximal ‐ 1 week 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?	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?			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?	Yes
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?		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?	No
If a threshold was used, was it pre‐specified?	Yes
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?		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?	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?			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?	No
Could the patient flow have introduced bias?		High risk