“…Twenty-three trials (all full-text publications) compared mpMRI with a reference standard (n=5, all cohort studies) or with TRUS-SB (n=18: 2 randomized controlled trials [RCTs] and 16 cohort studies) for biopsy-naive men. The certainty of the aggregate study evidence for each comparison showed 14 of the 21 cohort studies to be at either low 6,32,40 or moderate 7,9,11,2,14,16,18,22,25,33,44 risk of bias based on a GRADE approach. 48 One of the RCTs was assessed to be at low risks of bias 20 and the other was assessed at being at unclear risk.…”