Das 2009.

Study characteristics
Patient Sampling	15 patients with symptomatic stenosis of the internal carotid artery were included in this study. All patients underwent one Dual‐Source CTA, MRA and DUS of the supra‐aortic arteries, to assess the degree of stenosis of the internal carotid
Patient characteristics and setting	15 symptomatic patients were included, 12 men and 3 women Average age was 69 years (range 53–79 years) Risk factors not described
Index tests	DUS Image production: GE Vivid 7 (GE Healthcare, Milwaukee, USA) with a 7 Mhz probe Contrast: No Criteria used to determine grade of stenosis: DEGUM criteria (Appendix 9)
Target condition and reference standard(s)	Reference standard: CTA and MRA Target condition: symptomatic stenosis of the internal carotid Criteria used to determine grade of stenosis: NASCET criteria Complications: No
Flow and timing	All three investigations were made within a week.
Comparative
Methods	Study design: Prospective study, unclear whether consecutive recruitment Study location: Germany Year and language of publication: Published in 2009 in English Study period: between April 2007 and March 2008 Participants enrolled: 15 patients Carotids included in analyses: 30
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?	Unclear
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?			Unclear
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?			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?	Unclear
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?			Unclear
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?	Unclear
Could the patient flow have introduced bias?		Unclear risk