Sensitivity and specificity of machine learning and deep learning algorithms in the diagnosis of thoracolumbar injuries resulting in vertebral fractures: A systematic review and meta-analysis

Clinicians encounter challenges in promptly diagnosing thoracolumbar injuries (TLIs) and fractures (VFs), motivating the exploration of Artificial Intelligence (AI) and Machine Learning (ML) and Deep Learning (DL) technologies to enhance diagnostic capabilities. Despite varying evidence, the noteworthy transformative potential of AI in healthcare, leveraging insights from daily healthcare data, persists. This review investigates the utilization of ML and DL in TLIs causing VFs. Employing Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) methodology, a systematic review was conducted in PubMed and Scopus databases, identifying 793 studies. Seventeen were included in the systematic review, and 11 in the meta-analysis. Variables considered encompassed publication years, geographical location, study design, total participants (14,524), gender distribution, ML or DL methods, specific pathology, diagnostic modality, test analysis variables, validation details, and key study conclusions. Meta-analysis assessed specificity, sensitivity, and conducted hierarchical summary receiver operating characteristic curve (HSROC) analysis. Predominantly conducted in China (29.41%), the studies involved 14,524 participants. In the analysis, 11.76% (N = 2) focused on ML, while 88.24% (N = 15) were dedicated to deep DL. Meta-analysis revealed a sensitivity of 0.91 (95% CI = 0.86–0.95), consistent specificity of 0.90 (95% CI = 0.86–0.93), with a false positive rate of 0.097 (95% CI = 0.068–0.137). The study underscores consistent specificity and sensitivity estimates, affirming the diagnostic test's robustness. However, the broader context of ML applications in TLIs emphasizes the critical need for standardization in methodologies to enhance clinical utility. •ML and DL in vertebral fractures ensure accurate and timely diagnostics.•China leads in AI for TL spine diagnostics, trailed by Taiwan and South Korea.•Meta-Analysis reveals sensitivity of 0.91 (95% CI = 0.86–0.95).•Notable diagnostic accuracy - specificity 0.90 (95% CI = 0.86–0.93), DOR 94.603.