Table 3 Overview of concerns about risk of bias and applicability of studies using standalone DL systems or assistive DL systems.

From: Diagnostic performance of deep learning in ultrasound diagnosis of breast cancer: a systematic review

Study

Risk of bias QUADAS-2

Applicability concerns QUADAS-2

Risk of bias QUADAS-C

P

I

R

FT

P

I

R

P

I

R

FT

Standalone DL system

Kim 202118

Low

High

High

High

High

High

Low

High

Low

Low

Low

Xiao 201919

Unclear

Low

Low

Low

High

High

Low

High

Low

Low

Low

Cho 201820

Low

Low

Low

Low

High

High

Low

Low

Low

Low

Low

Segni 201822

Unclear

Low

High

High

High

High

High

High

Low

High

High

Lee 202224

High

Low

Low

Low

High

High

Low

High

Low

Low

Low

Xia 202123

Low

Low

Low

Low

High

High

Low

Low

Unclear

Low

Low

Choi 201925

Low

Low

High

High

High

High

High

Low

Low

High

High

Nicosia 202226

Low

Low

Low

Low

High

High

Low

Low

Low

Low

Low

Lai 202227

Unclear

Low

Low

Low

High

High

Low

High

Low

Low

Low

Lee 201928

High

Low

High

High

High

High

High

High

Low

High

High

Wei 202129

High

Low

Low

Low

High

High

Low

High

Low

Low

Low

Wei 202230

High

Low

Low

Low

High

High

Low

High

Low

Low

Low

Ciritsis 201931

High

Low

Unclear

Unclear

High

High

Unclear

High

Low

High

High

Gu 202232

Unclear

Low

Low

Low

High

High

Low

High

Low

Low

Low

Assistive DL system

Park 201917

Unclear

Low

High

High

High

High

High

High

Low

High

High

Kim 202118

High

Low

Low

Low

High

High

Low

High

High

Low

Low

Cho 201820

Low

Low

Low

Low

High

High

Low

Low

High

Low

Low

Wang 202121

Low

Low

Low

Low

High

High

Low

Low

High

Low

Low

Xia 202123

Low

Low

Low

Low

High

High

Low

High

Low

Low

Low

Lee 202224

High

Low

Low

Low

High

High

Low

High

Low

Low

Low

Choi 201925

Low

Low

High

High

High

High

High

Low

High

High

High

Lai 202227

Unclear

Low

Low

Low

High

High

Low

High

Low

Low

Low

Lee 201928

High

High

High

High

High

High

High

High

High

High

High

Wei 202129

High

Low

Low

Low

High

High

Low

High

High

Low

Low

Wei 202230

High

Low

Low

Low

High

High

Low

High

High

Low

Low

Gu 202232

Unclear

Low

Low

Low

High

High

Low

High

Low

Low

Low

  1. P patient selection, I index tests, R reference standard, FT flow and timing.