Table 3.

The revised QUADAS-2 tool for risk of bias assessment

Domains	Signal questions	Answers
“Patient” (literature) Selection	Risk of bias
	Was a consecutive or random sample of literatures enrolled	Yes/no/unclear
	Was a case-control design avoided	Yes/no/unclear
	Did the study avoid inappropriate exclusions	Yes/no/unclear
	Could the selection of literatures have introduced bias	Low/high/unclear risk
	Concerns regarding applicability
	Is there concern that the included literatures do not match the review question	Low/high/unclear risk
Index test (AI algorithms in literature screening)	Risk of bias
	Were the index test results interpreted without knowledge of the results of the reference standard	Yes/no/unclear
	If a threshold was used, was it pre-specified	Yes/no/unclear
	Could the conduct or interpretation of the index test have introduced bias	Low/high/unclear risk
	Concerns regarding applicability
	Is there concern that the index test, its conduct, or interpretation differ from the review question	Low/high/unclear risk
Reference standard (results of screening by human investigators)	Risk of bias
	Is the reference standard likely to correctly classify the target condition	Yes/no/unclear
	Were the reference standard results interpreted without knowledge of the results of the index test	Yes/no/unclear
	Could the reference standard, its conduct, or its interpretation have introduced bias	Low/high/unclear risk
	Concerns regarding applicability
	Is there concern that the target condition as defined by the reference standard does not match the review question	Low/high/unclear risk
Flow and timing	Risk of bias
	Did all literatures receive a reference standard	Yes/no/unclear
	Did literatures receive the same reference standard	Yes/no/unclear
	Were all literatures included in the analysis	Yes/no/unclear
	Could the literature flow have introduced bias	Low/high/unclear risk