Schneider 2017.

Study characteristics
Patient Sampling	Prospective
Patient characteristics and setting	Study location: Austria Study periods: between July 2015 and July 2016 Care setting: Medical University of Vienna Participants enrolled: 65: 28 males and 37 females Participants included in analysis: 65: 28 males and 37 females Age: mean age 67.2 years (range: 19‐89 years) BMI: not reported Classification of PH defined by WHO (diagnosis from right‐heart catheterisation): Class I: 8, Class II: 23, Class III: 10, Class IV: 13, Class V: 0 Number of patients with asymptomatic or mild symptom: not reported Number of participants with COPD: not reported Number of intubated participants: 0 Inclusion criteria: We prospectively included all adult patients with clinically indicated right‐heart catheterisation between July 2015 and July 2016. Exclusion criteria: Patients less than 18 years old were excluded.
Index tests	Description of index test: Transthoracic echocardiograms (2D, Doppler) were performed with echocardiography systems equipped with 3.5 MHz transducers (Vivid E9, Vivid S70; General Electric Healthcare) according to the recommendations and guidelines by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. In all patients, peak continuous wave Doppler velocity of the tricuspid regurgitation jet was systematically measured in the parasternal long‐axis view of the right ventricular inflow, the parasternal short axis view of the basal right ventricular, the right ventricular modified apical four chamber view, the apical long axis view of right ventricular inflow, and the subcostal four chamber view. Description of method to estimate right atrial pressure: none Cut‐off value to declare PH: 34 mmHg Estimated systolic pulmonary arterial pressure: not reported Sonographer qualification: performed by experienced physician How to handle the uninterpretable results: not applicable
Target condition and reference standard(s)	Target condition: pulmonary hypertension Description of reference standard: Haemodynamic measurements were performed using a 7F Swan‐Ganz catheter (Edwards Lifesciences GmbH, Austria) via a femoral access. Pressures were documented as average of eight measurements over eight consecutive heart cycles using CathCorLX (Siemens AG, Berlin and Munich, Germany). Mean pulmonary arterial pressure: mean 37.6 ± 14.9 mmHg
Flow and timing	The interval between the index test and reference standard: within 1 day Number of indeterminates for whom the results of reference standard was available: 0 (0%) Number of patients who were excluded from the analysis: 0 (0%)
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?	Unclear
If a threshold was used, was it pre‐specified?	Yes
Could the conduct or interpretation of the index test have introduced bias?		Unclear risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			High
DOMAIN 3: Reference Standard
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
Were the criteria of reference standard for target condition prespecified?	Yes
Could the reference standard, its conduct, or its interpretation have introduced bias?		Unclear 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?	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