60 Chapter 2 medication use in the last week before nasal challenge, nasal polyps, sinusitis, upper airway abnormalities Was a consecutive or random sample of patients enrolled? Yes/no/unclear Was a case-control design avoided? Yes/no/unclear Did the study avoid inappropriate exclusions? Yes/no/unclear Could the selection of patients have introduced bias? RISK: LOW/HIGH/UNCLEAR B. Concerns regarding applicability Describe included patients (prior testing, intended use of index test and setting) See above Is there concern that the included patients do not match the review question? CONCERN: LOW/HIGH/UNCLEAR (little concern, since the restriction of the participant group because of exclusion criteria, such as non-smokers, and absence of systemic diseases; this thus not fully represent the real target population for the test) Domain 2: Index test A. Risk of bias Describe the index test and how it was conducted and interpreted See above Were the index test results interpreted without knowledge of the results of the reference standard? Yes/no/unclear If a threshold was used, was it prespecified? Yes/no/unclear Could the conduct or interpretation of the index test have introduced bias? RISK: LOW/HIGH/UNCLEAR B. Concerns regarding applicability Is there concern that the index test, its conduct, or interpretation, differ from the review question? CONCERN: LOW/HIGH/UNCLEAR Domain 3: Reference standard A. Risk of bias Describe the reference standard and how it was conducted and interpreted See above Is the reference standard likely to correctly classify the target condition? Yes/no/unclear Were the reference standard results interpreted without knowledge of the results of the index test? Yes/no/unclear Could the reference standard, its conduct, or its interpretation have introduced bias? RISK: LOW/HIGH/UNCLEAR (possible difference in approach depending on test result, although the authors state that personnel has been trained to avoid this) B. Concerns regarding applicability Is there concern that the target condition as defined by the reference standard does not match the review question? CONCERN: LOW/HIGH/UNCLEAR Domain 4: Flow and timing A. Risk of bias Describe any patients who did not receive the index test(s) and/or reference standard or who were excluded from the 2x2 table 4 patients declined or had unsuccessful venipuncture. All patients received the reference standard.
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