Bray 1995.

Study characteristics
Patient Sampling	Patientes referred to the radiology department for DSA of the supra‐aortic vessels were consecutively included. Exclusion criteria not described
Patient characteristics and setting	64 patients, 53 men and 11 women, mean age 62.6 +‐ 13.5 years 28 had an established stroke, 19 had only transient Ischemic attacks (TIA). There were 12 with a cervical bruit, and 5 had a cerebral hemorrhage. Risk factors not described
Index tests	DUS Image production: The device has not been specified but performed with a 7 MHz linear probe. Contrast: No Criteria used to determine grade of stenosis: Appendix 9
Target condition and reference standard(s)	Reference standard: DSA Target condition: suspected for carotid disease patients Criteria used to determine grade of stenosis: quantitative measurement of the ratio between the diameters of the residual lumen of the stenosis and the presumably normal carotid artery was made, usually 4 cm beyond the carotid bulb. Complications: Not described
Flow and timing	7 other patients were excluded from the consecutive series because of incomplete or delayed investigations. DUS were performed in the 24 h prior to angiography. Did not describe prior testing, but included only patients referred to DSA of supra‐aortic vessels
Comparative
Methods	Study design: Prospective, consecutive, accuracy cohort study Study location: France Year and language of publication: Published in 1995 in English. Study period: Not described Participants enrolled: 64 patients. Carotids included in analyses: 128
Notes	Did not describe whether patients had undergone any screening imaging test before being included in the study
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	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?			High
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?	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?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	Yes
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 there an appropriate interval between index test and reference standard?	Yes
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