Pinelli 2002.

Study characteristics
Patient Sampling	Method of sampling: selected Included conditions: no cavitation and early lesions, "none of the teeth showed macroscopic signs of cavity formation with exposure into dentin" Teeth: permanent molars, "the inclusion criterion was the presence of at least one white‐spot caries lesion on a free smooth surface" Sealants: not reported Surface: "free smooth surfaces"
Patient characteristics and setting	Age: 11 to 17 years Sex: not reported Ethnicity: not reported Country: Brazil Setting: school, "The examinations were carried out in classrooms under good light conditions" Number of participants/teeth/sites: 50 participants/220 surfaces Prevalence: enamel 0.50
Index tests	Category of test: DIAGNOdent Sequence of test(s): visual then DIAGNOdent Examiner training and calibration: yes Teeth cleaning prior to examination: floss and brush Tooth drying prior to examination: air dried, 10 seconds Threshold applied: 0‐4 arrested, 5+ active Device specifics: "DIAGNOdent was used to examine only the lesions detected by visual inspection"
Target condition and reference standard(s)	Category: visual Sequence of index test and reference standard: reference standard performed before index test Training of examiner: calibration completed Blinding to index test: yes Multiple tests: no Site selection: those identified visually Target condition: active or inactive 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: 1 week to allow for separation of teeth Participants receiving both tests but excluded from results: 0
Comparative
Notes	Inclusion criteria suggests sound teeth were excluded, but the results confirm that sound teeth were present in the sample
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)?
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?	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?	Yes
Were all patients included in the analysis?	Yes
Could the patient flow have introduced bias?		Low risk