目的:颞下颌关节紊乱病的准确诊断仍然是一个挑战,尽管存在国际公认的诊断标准。本研究的目的是回顾深度学习模型在颞下颌关节病诊断中的应用。
方法:在PubMed上进行了电子搜索,Scopus,Embase,谷歌学者,IEEE,arXiv,和medRxiv直到2023年6月。报告预测功效(结果)的研究,包括通过深度学习模型(干预)与参考标准(比较)相比,基于人类关节的或关节性TMD(群体)的TMJ关节病的对象检测或分类。为了评估偏差的风险,纳入的研究采用诊断准确性研究的质量评估(QUADAS-2)进行批判性分析.计算诊断比值比(DOR)。使用STATA17和MetaDiSc创建福雷斯特图和漏斗图。
结果:对1056项确定的研究中的46项进行了全文综述,其中21项研究符合资格标准并纳入系统综述。四项研究被评为对QUADAS-2的所有领域具有低偏倚风险。所有纳入研究的准确性范围为74%至100%。敏感度从54%到100%,特异性:85%-100%,骰子系数:85%-98%,AUC:77%-99%。然后根据敏感性汇集数据集,特异性,以及符合荟萃分析条件的七项研究的数据集大小。合并敏感性为95%(85%-99%),特异性:92%(86%-96%),和AUC:97%(96%-98%)。DOR为232(74-729)。根据Deek的漏斗图和统计评估(p=.49),不存在发表偏倚.
结论:深度学习模型可以高灵敏度和特异性地检测TMJ关节病。临床医生,尤其是那些不是专门治疗口面部疼痛的人,可能会受益于这种评估TMD的方法,因为它促进了严格和基于证据的框架,客观测量,和先进的分析技术,最终提高诊断的准确性。
OBJECTIVE: The accurate diagnosis of temporomandibular disorders continues to be a challenge, despite the existence of internationally agreed-upon diagnostic criteria. The purpose of this study is to review applications of deep learning models in the diagnosis of temporomandibular joint arthropathies.
METHODS: An electronic search was conducted on PubMed, Scopus, Embase, Google Scholar, IEEE, arXiv, and medRxiv up to June 2023. Studies that reported the efficacy (outcome) of prediction, object detection or classification of TMJ arthropathies by deep learning models (intervention) of human joint-based or arthrogenous TMDs (population) in comparison to reference standard (comparison) were included. To evaluate the risk of bias, included studies were critically analysed using the quality assessment of diagnostic accuracy studies (QUADAS-2). Diagnostic odds ratios (DOR) were calculated. Forrest plot and funnel plot were created using STATA 17 and MetaDiSc.
RESULTS: Full text review was performed on 46 out of the 1056 identified studies and 21 studies met the eligibility criteria and were included in the systematic review. Four studies were graded as having a low risk of bias for all domains of QUADAS-2. The accuracy of all included studies ranged from 74% to 100%. Sensitivity ranged from 54% to 100%, specificity: 85%-100%, Dice coefficient: 85%-98%, and AUC: 77%-99%. The datasets were then pooled based on the sensitivity, specificity, and dataset size of seven studies that qualified for meta-analysis. The pooled sensitivity was 95% (85%-99%), specificity: 92% (86%-96%), and AUC: 97% (96%-98%). DORs were 232 (74-729). According to Deek\'s funnel plot and statistical evaluation (p =.49), publication bias was not present.
CONCLUSIONS: Deep learning models can detect TMJ arthropathies high sensitivity and specificity. Clinicians, and especially those not specialized in orofacial pain, may benefit from this methodology for assessing TMD as it facilitates a rigorous and evidence-based framework, objective measurements, and advanced analysis techniques, ultimately enhancing diagnostic accuracy.