Di Carlo 2012.
| Study characteristics | |||
| Patient Sampling | Study prospectively evaluated the accuracy of CEUS and MRI for the diagnosis of small nodules detected during US surveillance in people with cirrhosis. It included prospective evaluation of 89 people with cirrhosis. | ||
| Patient characteristics and setting | People with cirrhosis were screened by US and suspected cases were referred to CEUS and MRI. | ||
| Index tests | Index test positivity criteria: intense arterial uptake followed by washout in the venous/delayed phase was registered as conclusive for HCC. Radiologists were unaware of the final diagnosis of the lesion. |
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| Target condition and reference standard(s) | Reference standards: used AASLD criteria and concordance of 2 contrast tests (CEUS and MRI). Used CEUS and MRI as confirmatory tests. | ||
| Flow and timing | Time between index test and reference standard not reported. Not all participants received the same reference standard. | ||
| Comparative | |||
| Notes | Information regarding COI and funding not reported. | ||
| Methodological quality | |||
| Item | Authors' judgement | Risk of bias | Applicability concerns |
| DOMAIN 1: Patient Selection | |||
| Was a consecutive or random sample of patients enrolled? | Yes | ||
| Did the study avoid inappropriate exclusions? | Unclear | ||
| 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 tests) | |||
| Were the index test results interpreted without knowledge of the results of the reference standard? | Yes | ||
| Were positivity criteria clearly defined? | 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 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? | High | ||
| DOMAIN 4: Flow and Timing | |||
| Was there an appropriate interval between index test and reference standard? | Unclear | ||
| Did all patients receive the same reference standard? | No | ||
| Were all patients included in the analysis? | Yes | ||
| Could the patient flow have introduced bias? | High risk | ||