Golledge 1999.

Study characteristics
Patient Sampling	Selected symptomatic patients admitted to the hospital
Patient characteristics and setting	50 patients, all symptomatic 62% men and 38% women. Median age 71 years (range from 47 to 84 years)
Index tests	DUS Image production: duplex scan imaging was performed with a 5‐MHz probe (angle of insonation, 60 degrees; Ultramark 9, HDI, Advanced Technology Laboratories, Wash.). Contrast: No Criteria used to determine grade of stenosis: ROC curve analysis
Target condition and reference standard(s)	Reference standard: DSA Target condition: carotid artery stenosis Criteria used to determine grade of stenosis: NASCET Complications: No significant complications
Flow and timing	DSA was performed within 24 hours from DUS.
Comparative
Methods	Study design: Unclear whether prospective design Study location: UK Year and language of publication: Published in 1999 in English Study period: June 1996 to June 1997 Participants enrolled: 50 patients Carotids included in analyses: 100 arteries
Notes
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?	Yes
If a threshold was used, was it pre‐specified?	No
Could the conduct or interpretation of the index test have introduced bias?		High 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?	Yes
Could the patient flow have introduced bias?		Low risk