Patient selection | Index test | Reference standard | Flow and timing | Reviewer comments | ||||
---|---|---|---|---|---|---|---|---|
Risk of bias | Concerns about applicability | Risk of bias | Concerns about applicability | Risk of bias | Concerns about applicability | Risk of bias | ||
Affifi (2003) [27] | Low | Low | Low | Low | High | High | Low | Sensitivity and specificity cannot be calculated due to reference standard related bias (reference standard is incorrect due to the use of self-report in combination with signs upon physical examination, which is likely to underestimate true prevalence) |
Palazzi (2005) [28] | High | Low | Low | Unclear | High | Low | High | Sensitivity and specificity cannot be calculated, due to i) reporting bias (cumulative prevalence of at least 1 positive finding upon physical examination not being reported) and ii) incorporation bias (results of physical examination are used in establishing the reference standard) |
Rosenberg (1982) [29] | Low | Low | Low | Unclear | High | Low | High | Sensitivity and specificity cannot be calculated, due to i) different timing of application of the reference standard, ii) reporting bias (cumulative prevalence of at least 1 positive finding upon physical examination not being reported) and iii) information bias (due to a different definition of physical signs of maltreatment used at the time) |