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Table 2 Signalling questions for QUADAS-2 quality assessment

From: Evaluating the diagnostic pathway for acute ACL injuries in trauma centres: a systematic review

Signaling questions for QUADAS-2 quality assessment

Domain 1: patient selection

 A: risk or bias

Was a consecutive or random sample of patients enrolled?

Did the study have appropriate exclusions?

Was the study retrospective?

Was a sufficient sample size used?

Could the selection or patient have introduced bias?

 B: concerns regarding applicability

Are there concerns that the included patients do not match the review question?

Domain 2: index test(s)

 A: risk or bias

Were the index test results interpreted without knowledge of the results of the reference standard?

Were all the index tests specified and clearly explained?

Could the conduct or interpretation of the index test have introduced bias?

 B: concerns regarding applicability

Is there concern that the index test, its conduct, or interpretation differ from the review question?

Domain 3: reference standard

 A: risk or bias

Is the reference standard the ‘gold standard’ for ACL diagnosis?

Were the reference standard results interpreted without knowledge of the results of the index test?

Could the reference standard, its conduct, or its interpretation, have introduced bias?

 B: concerns regarding applicability

Is there concern that the target condition as defined by the reference standard does not match the review question?

Domain 4: flow and timing

 A: risk of bias

Was there an appropriate interval between the index test and the reference standard?

Was the time frame defined where the initial consultation (index test) and/or reference standard was completed? /Unclear

Did all patients receive a reference standard?

Did all patients receive the same reference standard?

Were all patients included in the analysis?

Could the patient flow have introduced bias?