Machine learning-based medical imaging diagnosis in patients with temporomandibular disorders: a diagnostic test accuracy systematic review and meta-analysis

Objectives Temporomandibular disorders (TMDs) are the second most common musculoskeletal condition which are challenging tasks for most clinicians. Recent research used machine learning (ML) algorithms to diagnose TMDs intelligently. This study aimed to systematically evaluate the quality of these studies and assess the diagnostic accuracy of existing models. Materials and methods Twelve databases (Europe PMC, Embase, etc.) and two registers were searched for published and unpublished studies using ML algorithms on medical images. Two reviewers extracted the characteristics of studies and assessed the methodological quality using the QUADAS-2 tool independently. Results A total of 28 studies (29 reports) were included: one was at unclear risk of bias and the others were at high risk. Thus the certainty of evidence was quite low. These studies used many types of algorithms including 8 machine learning models (logistic regression, support vector machine, random forest, etc.) and 15 deep learning models (Resnet152, Yolo v5, Inception V3, etc.). The diagnostic accuracy of a few models was relatively satisfactory. The pooled sensitivity and specificity were 0.745 (0.660–0.814) and 0.770 (0.700–0.828) in random forest, 0.765 (0.686–0.829) and 0.766 (0.688–0.830) in XGBoost, and 0.781 (0.704–0.843) and 0.781 (0.704–0.843) in LightGBM. Conclusions Most studies had high risks of bias in Patient Selection and Index Test. Some algorithms are relatively satisfactory and might be promising in intelligent diagnosis. Overall, more high-quality studies and more types of algorithms should be conducted in the future. Clinical relevance We evaluated the diagnostic accuracy of the existing models and provided clinicians with much advice about the selection of algorithms. This study stated the promising orientation of future research, and we believe it will promote the intelligent diagnosis of TMDs.