Nowak 2018.

Study characteristics
Patient Sampling	Retrospective
Patient characteristics and setting	Study location: Poland Study periods: between April 2007 and December 2011 Care setting: the Silesian Center of Heart Disease Participants enrolled: 65: 49 males and 16 females Participants included in analysis: 37: males and females Age: mean age 53.3 ± 9.5 years BMI: mean 24.1 ± 4.3 Classification of PH defined by WHO (diagnosis from right‐heart catheterisation): not reported Number of patients with asymptomatic or mild symptom: 2 (3%) Number of participants with COPD: 31 Number of intubated participants: 0 Inclusion criteria: patients with advanced lung disease who underwent right‐heart catheterisation Exclusion criteria: patients with IPH were excluded.
Index tests	Description of index test: All patients underwent transthoracic echocardiography, including M‐mode, 2‐dimensional, pulsed, continuous‐wave, and colour‐flow Doppler imaging using the GE VIVID 5 system and a transducer array of 2.5 MHz, according to the guidelines of the American Society of Cardiology. Description of method to estimate right atrial pressure: not reported Cut‐off value to declare PH: 43 mmHg Estimated systolic pulmonary arterial pressure: mean 54.2 ± 21.5 mmHg Sonographer qualification: not reported How to handle the uninterpretable results: excluded from analysis
Target condition and reference standard(s)	Target condition: pulmonary hypertension Description of reference standard: All patients were clinically stable with no changes in medical therapy. This procedure was performed at rest in supine position, using a Swan‐ganz catheter. Measurements were performed using supplemental oxygen, if needed, to achieve saturation over 90%. Mean pulmonary arterial pressure: mean 28.8 ± 11.5 mmHg
Flow and timing	The interval between the index test and reference standard: mean interval 3 days ± 1.7 days Number of indeterminates for whom the results of reference standard was available: 0 (0%) Number of patients who were excluded from the analysis: not stated
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?	Yes
Did the study avoid inappropriate exclusions?	Yes
Could the selection of patients have introduced bias?		Low 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
If a threshold was used, was it pre‐specified?	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?			Unclear
DOMAIN 3: Reference Standard
Were the reference standard results interpreted without knowledge of the results of the index tests?	Yes
Were the criteria of reference standard for target condition prespecified?	Unclear
Could the reference standard, its conduct, or its interpretation have introduced bias?		Low 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 the interval between the index test and reference standard less than one day?	No
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	No
Could the patient flow have introduced bias?		High risk