Cuthbertson 2007.

Study characteristics
General information	Objective  Added biomarkers, biomarkers compared Journal British Journal of Anaesthesia Country United Kingdom  Study design Prospective cohort study
Participants	Number of included patients 204 Surgical specialty Noncardiac surgery Age Mean 66 years (range = 28 to 79 years) Male sex 61% High‐risk surgery Not reported Insulin‐dependent diabetes mellitus Not reported History of ischaemic heart disease Not reported History of congestive heart failure Not reported History of cerebrovascular events Not reported Elevated creatinine Not reported 0 RCRI factors Not reported 1 RCRI factor Not reported 2 RCRI factors Not reported 2 or more RCRI factors 32%
Predictors	Outcome category All‐cause mortality and MACE Full outcome definition All‐cause mortality or troponin elevation Prediction horizon Within the first 3 postoperative days
Outcome	Outcome category All‐cause mortality and MACE Full outcome definition All‐cause mortality or troponin elevation Prediction horizon Within the first 3 postoperative days
Analysis	Number of outcomes 12         Handling missing data No information on handling missing data Discrimination reported? Yes Calibration reported? No  Reclassification reported? No
PROBAST: Applicability	Domain 1: Participant selection Low Justification: not applicable Domain 2: Predictors Unclear Justification: no information on predictor definitions Domain 3: Outcome High Justification: outcome different from the development study Overall judgement High Justification: patient selection was appropriate. However, there was no/unclear information on predictor definitions. In addition, the outcome used was different from MACE in the development study.
Notes	—
Item	Authors' judgement	Support for judgement
Domain 1: Participant selection	Yes	Appropriate participant selection in which patients were selected in whom the RCRI model can be applied.
Domain 2: Predictors	Unclear	No information on predictor definitions.
Domain 3: Outcome	Yes	Clearly defined outcome definitions and appropriate adjudication of outcomes.
Domain 4:  Analysis	No	The number of events was low; there was no information on handling missing data.
Overall judgement	No	Appropriate patient selection and outcomes definitions were clearly defined and assessed. However, there was no/unclear information on predictor definitions, the number of outcomes was low and no information on handling of missing data was reported.