Hansen 1996.

Study characteristics
Patient Sampling	Patients with a planned carotid endarterectomy sent to be examined with DUS and DSA; unclear where the patients were selected and exams performed previously Exclusion criteria not described
Patient characteristics and setting	81 consecutive patients (22 women and 59 men), aged 49‐83 years (mean 68 years) 89% symptomatic patients: 28 patients (34.5%) had had minor strokes, 32 (39.5%) transient ischemic attacks (TIA), and 12 (15%) amaurosis fugax. 9 (11%); those previously undergoing an endarterectomy on the symptomatic side, were operated on because of a contralateral asymptomatic severe stenosis.
Index tests	DUS Image production: Acuson XP 10 (Acuson, Mountain View, CA, U.S.A.), using either a 7 MHz B‐mode real‐time linear scanner including a 5 MHz pulsed and color‐coded Doppler, or a 5 MHz B‐mode real‐time linear scanner including a 3.5 MHz pulsed and color‐coded Doppler Contrast: No Criteria used to determine grade of stenosis: ROC curve analysis
Target condition and reference standard(s)	Reference standard: DSA Target condition: internal carotid stenosis Criteria used to determine grade of stenosis: quote "Diameter reduction in percent = (b ‐ a)/b * 100. Where a is the smallest diameter in the stenotic zone, and b is the diameter of the normal CCA proximal to the stenosis." Complications: Not described
Flow and timing	All exams were performed within 1 month
Comparative
Methods	Study design: Prospective, consecutive, accuracy cohort study Study location: Sweden Year and language of publication: Published in 1996 in English Study period: Not described Participants enrolled: 81 patients Carotids included in analyses: 162 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?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	No
Could the selection of patients have introduced bias?		High 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?	Unclear
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?	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?			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?	Unclear
Could the patient flow have introduced bias?		Unclear risk