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©The Author(s) 2025.
World J Gastroenterol. Nov 21, 2025; 31(43): 112000
Published online Nov 21, 2025. doi: 10.3748/wjg.v31.i43.112000
Table 1 Summary of artificial intelligence models for acute appendicitis: Methods and performance metrics
No.
Ref.
Year
Country
Dataset size
Variables used
AI methods
Performance metrics
1Sibic et al[84]2025TurkeyAAp: 400; non-AAp: 400Demographic, and radiological data [CT images (CNN architectures)]MobileNet v2, ResNet v2, EfficientNet b2, Inception v3 (MobileNet v2 best results)Accuracy: 79.1; precision: 82.0; sensitivity: 74.7; F1 score: 78.1; AUC: 0.877
2Navaei et al[17]2025IranAAp: 465; non-AAp: 317Demographic, clinical and biochemical dataDT, RF, SVM, KNN, GBM, AdaBoost, XGBoost, LightBoost, CatBoost (RF best results)Accuracy: 94.6; sensitivity: 93.9; specificity: 95.7; F1 score: 93.6
3Li et al[8]2025ChinaCompl AAp: 88; uncompl AAp: 213Demographic, clinical and biochemical dataLR, SVM, RF, DT1, GBM, KNN, GNB, MLP (RF best results)Accuracy: 81.0; sensitivity: 76.0; specificity: 83.0; F1 score: 74.0; AUC: 0.840
4Kucukakcali et al[86]2025TurkeyCompl AAp: 34; uncompl AAp: 65; non-AAp: 41Demographic and biochemical dataSGB (non-AAp vs AAp)Accuracy: 96.3; sensitivity: 94.7; specificity: 100; F1 score: 97.3; AUC: 0.947
SGB (uncompl vs compl AAp)Accuracy: 78.9; sensitivity: 83.3; specificity: 76.9; F1 score: 71.4; AUC: 0.790
5Kucukakcali et al[87]2025TurkeyCompl AAp: 183; uncompl AAp: 290; negative AAp: 117Demographic and biochemical dataAdaBoost, XGBoost, SGB, bagged CART, RF (XGBoost best results)Accuracy: 80.0; sensitivity: 70.8; specificity: 85.4; F1 score: 72.3
AdaBoost, XGBoost, SGB, bagged CART, RF (XGBoost best results)Accuracy: 90.7; sensitivity: 100; specificity: 61.5; F1 score: 94.3
6Kim et al[29]2025South KoreaCompl AAp: 655; uncompl AAp: 2789; negative AAp: 551; non-AAp: 3058CT images (non vs uncomplicated)3D-CNN (transfer learning, ResNet/DenseNet/EfficientNet) (DenseNet best results)Accuracy: 79.5; sensitivity: 70.1; specificity: 87.6; AUC: 0.865
CT images (complicated vs uncomplicated)3D-CNN (transfer learning, ResNet/DenseNet/EfficientNet) (DenseNet best results)Accuracy: 76.1; sensitivity: 82.6; specificity: 74.2; AUC: 0.827
7Kendall et al[88]2025Compl AAp: 1192; uncompl AAp: 344; non-AAp: 317Demographic, clinical, biochemical and radiological dataRF, LightGBM, LR, SGD, KNN, Dummy, GANDALF, RF + embedded LightGBM (best result)Accuracy: 98.1; sensitivity: 97.8; specificity: 96.1; AUROC: 0.993
RF, LightGBM, LR, SGD, KNN, Dummy, GANDALF, LightGBM + filter FS (best result)Accuracy: 90.1; sensitivity: 78.8; specificity: 95.1; AUROC: 0.931
8Erman et al[35]2025CanadaCompl AAp: 602; uncompl AAp: 1378Demographic, clinical and biochemical dataML pipelineAccuracy: 70.1; NPV: 82.8; PPV: 56.4
9Chen et al[3]2025ChinaCompl AAp: 357; uncompl AAp: 416Demographic, clinical and biochemical dataXGBoost, RF, DT (CART), SVM (XGBoost best results)Accuracy: 85.5; sensitivity: 86.5; specificity: 84.6; AUC: 0.914
10Aydin et al[89]2025TurkeyCompl AAp: 296; uncompl AAp: 3658; non-AAp: 4632; validation: Compl AAp: 1580; Uncompl AAp: 1287; Non-AAp: 169Demographic, clinical, biochemical and radiological dataLR, KNN, SVM, CART, RF (RF best results for AAp diagnosis)Accuracy: 99.2; sensitivity: 99.8; specificity: 99.3; AUC: 0.996
LR, KNN, SVM, CART, RF (RF best results for severity of AAp)Accuracy: 99.2; sensitivity: 99.3; specificity: 99.1; AUC: 0.995
11Zhao et al[90]2024ChinaCompl AAp: 258; uncompl AAp: 76Demographic, clinical, biochemical and radiological data (CT images)Radiomics model (CT images), CT model (clinical and CT features), combined modelAccuracy: 75.4; sensitivity: 74.6; specificity: 82.6; AUC: 0.817
12Yazici et al[37]2024TurkeyCompl AAp: 142; uncompl AAp: 990Demographic, clinical and biochemical dataKNN, DT, LR, SVM, MLP, GNB (LR best result)Accuracy: 96.0; sensitivity: 60.0; specificity: 100
13Wei et al[40]2024ChinaCompl AAp: 103; uncompl AAp: 219Demographic, clinical and biochemical dataLR, CART, FR, SVM, Bayes, KNN, NN, FDA, GBM (GBM best result)Accuracy: 95.6; sensitivity: 91.7; specificity: 97.4; F1 score: 93.0
14Schipper et al[33]2024NetherlandsAAp: 167; non-AAp: 169Data including physical examinationXGBoostAUC: 0.919
Data including physical examination and biochemical dataXGBoostAUC: 0.923
15Roshanaei et al[36]2024IranAAp: 138; non-AAp: 396Demographic, clinical and biochemical dataGNBAccuracy: 95.0; sensitivity: 87.2; specificity: 97.5; F1 score: 89.0
16Marcinkevičs et al[52]2024GermanyCompl AAp: 97; uncompl AAp: 482Radiological data (US images) (diagnosis)CBM; MVCBM; SSMVCBMAUROC: 0.800; AUPR: 0.920
Radiological data (US images) (severity)CBM; MVCBM; SSMVCBMAUROC: 0.780; AUPR: 0.580
17Males et al[39]2024CroatiaCompl AAp: 252; uncompl AAp: 252; negative AAp: 47 (pediatric cases)Demographic, clinical and biochemical dataRFSensitivity: 99.7; specificity: 17.0
XGBoostSensitivity: 99.8; specificity: 12.0
LRSensitivity: 99.7; specificity: 5.2
18Liang et al[91]2024ChinaTraining cohort: Compl AAp: 236; uncompl AAp: 464; validation cohort: Compl AAp: 182; uncompl AAp: 283Demographic, clinical, biochemical and radiological dataConventional combined model (clinical + CT features); deep learning radiomics (DL + radiomics) our combined model (clinical + CT + DL + radiomics) radiologist’s diagnosisAccuracy: 79.0; sensitivity: 66.5; specificity: 85.3; AUC: 0.816
Accuracy: 72.5; sensitivity: 70.2; specificity: 73.9; AUC: 0.799
19Gollapalli et al[38]2024Saudi Arabia411 patients3Demographic, clinical and biochemical dataDT (experiment 1)Accuracy: 75.0; sensitivity: 13.8; precision: 40.0; F1 score: 20.5
KNN (experiment 1)Accuracy: 83.1; sensitivity: 41.4; precision: 75.0; F1 score: 53.3
DT (experiment 2)Accuracy: 87.4; sensitivity: 91.2; precision: 83.8; F1 score: 87.4
KNN (experiment 2)Accuracy: 84.7; sensitivity: 84.6; precision: 83.7; F1 score: 84.2
KNN bagging (experiment 3)Accuracy: 92.1; sensitivity: 91.2; precision: 92.2; F1 score: 91.7
DT bagging (experiment 3)Accuracy: 89.5; sensitivity: 83.5; precision: 93.8; F1 score: 88.4
Stacking (experiment 4)Accuracy: 92.6; sensitivity: 89.0; precision: 95.3; F1 score: 92.0
20Chadaga et al[42]2024IndiaAAp: 465; non-AAp: 317 (pediatric cases)Demographic, clinical and biochemical dataRF, LR, DT, KNN, AdaBoost, CatBoost, LightGBM, XGBoost, APPSTACK. Bayesian optimization, hybrid bat algorithm, hybrid self-adaptive bat algorithm, firefly algorithm, grid search, randomized search (hybrid bat algorithm with APPSTACK best results)Accuracy: 94.0; sensitivity: 74.0; precision: 85.0; F1 score: 78.0; AUC: 0.960
21Abu-Ashour et al[41]2024CanadaAAp: 2100 (pediatric cases)Ultrasound reportsHumanPrecision: 57.3; sensitivity: 88.1; F score: 69.4
ChatGPT (large language model)Precision: 92.3; sensitivity: 68.4; F score: 78.5
Operative reportsHumanPrecision: 59.2; sensitivity: 95.3; F score: 73.1
ChatGPT (large language model)Precision: 97.1; sensitivity: 75.8; F score: 85.1
22Phan-Mai et al[46]2023VietnamCompl AAp: 483; uncompl AAp: 1467Demographic, clinical and biochemical dataSVM (SMOTE-adjusted)Accuracy: 65.5; AUC: 0.730
DT (SMOTE-adjusted)Accuracy: 73.8; AUC: 0.738
KNN (SMOTE-adjusted)Accuracy: 74.1; AUC: 0.831
LR (SMOTE-adjusted)Accuracy: 72.9; AUC: 0.789
ANN (SMOTE-adjusted)Accuracy: 74.2; AUC: 0.810
GBM (SMOTE-adjusted)Accuracy: 82.0; AUC: 0.890
23Pati et al[30]2023IndiaCompl AAp: 514; uncompl AAp: 196; non-AAp: 183 (pediatric cases)Demographic, clinical, biochemical and radiological dataLR, NB, KNN, SVM, DT, RF, MLP, AdaBoost (RF best for diagnostic)Accuracy: 91.6; precision: 89.0; sensitivity: 92.0; specificity: 91.3; F1 score: 90.4
LR, NB, KNN, SVM, DT, RF, MLP, AdaBoost (AdaBoost best for complication prediction)Accuracy: 92.2; precision: 94.6; sensitivity: 96.3; specificity: 68.6; F1 score: 95.4
24Park et al[45]2023South KoreaAAp: 246; non-AAp: 215; diverticulitis: 254CT imagesCNN-EfficientNet algorithm (single image method)Accuracy: 86.1; precision: 85.4; sensitivity: 85.6; specificity: 86.5; AUC: 0.937
CT imagesCNN-EfficientNet algorithm (RGB method)Accuracy: 87.9; precision: 87.1; sensitivity: 87.9; specificity: 88.1; AUC: 0.951
25Lin et al[93]2023TaiwanCompl AAp: 49; uncompl AAp: 362Demographic, clinical, biochemical and radiological data9 different MLP-ANN analyzed (Lin et al[93] ANN model best results)AUC: 0.897; sensitivity: 85.7; specificity: 91.7
26Li et al[92]2023ChinaCompl AAp: 141; uncompl AAp: 201 (pregnant patients)Demographic, clinical, biochemical and radiological dataDTAUC: 0.780
27Harmantepe et al[44]2023TurkeyAAp: 189; negative AAp: 156Demographic and biochemical dataLR, SVM, NN, KNN, voting classifier (voting best result)Accuracy: 86.2; sensitivity: 83.7; specificity: 88.6
28Akbulut et al[43]2023TurkeyCompl AAp: 304; uncompl AAp: 1161; negative AAp: 332Demographic and biochemical dataCatBoost + SHAP (non-AAp vs AAp)Accuracy: 88.2; sensitivity: 84.2; specificity: 93.2; F1 score: 88.7; AUC: 0.947
CatBoost + SHAP (compl vs uncompl AAp)Accuracy: 92.0; sensitivity: 94.1; specificity: 90.5; F1 score: 91.1; AUC: 0.969
29Xia et al[51]2022ChinaCompl AAp: 148; uncompl AAp: 150Demographic and clinical dataSVMAccuracy: 83.6; sensitivity: 81.7; specificity: 85.3; Matthews: 0.6732
30Su et al[49]2022United StatesAAp: 28002; non-AAp: 655 (adult cases)Demographic and clinical dataLRAccuracy: 96.0; sensitivity: 73.0; specificity: 68.0; AUC: 0.780
RFAccuracy: 97.0; sensitivity: 67.0; specificity: 71.0; AUC: 0.750
AAp: 11128; non-AAp: 256 (pediatric cases)Demographic and clinical dataLRAccuracy: 95.0; sensitivity: 81.0; specificity: 78.0; AUC: 0.870
RFAccuracy: 96.0; sensitivity: 82.0; specificity: 75.0; AUC: 0.860
31Shikha and Kasem[48]2023BruneiCompl AAp: 25; uncompl AAp: 24; negative AAp: 97 (pediatric cases)Demographic, Clinical, and biochemical dataAI pediatric appendicitis DTAccuracy: 97.1; sensitivity: 96.7; specificity: 97.4
32Mijwil and Aggarwal[47]2022IraqAppendectomy: 3185; medical: 307Demographic, and biochemical dataRF, LR, NB, GLM, DT, SVM, GBT (RF best results)Accuracy: 83.8; precision: 84.1; sensitivity: 81.1; specificity: 81.0
33Akgül et al[50]2021TurkeyCompl AAp: 45; uncompl AAp: 147; negative AAp: 24; non-AAp: 106 (pediatric cases)Demographic, clinical, biochemical and radiological dataANNSensitivity: 89.8; specificity: 81.2; AUC: 0.910
34Marcinkevics et al[53]2021GermanyCompl AAp: 51; uncompl AAp: 196; non-AAp: 183 (pediatric cases)Demographic, clinical, biochemical and radiological dataLR (diagnostic)Sensitivity: 88.0; specificity: 76.0; AUC: 0.910
RF (diagnostic)Sensitivity: 91.0; specificity: 86.0; AUC: 0.960
GBM (diagnostic)Sensitivity: 93.0; specificity: 86.0; AUC: 0.960
LR (severity)Sensitivity: 93.0; specificity: 42.0; AUC: 0.820
RF (severity)Sensitivity: 98.0; specificity: 45.0; AUC: 0.900
GBM (severity)Sensitivity: 97.0; specificity: 46.0; AUC: 0.900
35Aparicio et al[79]2021SwitzerlandAAp: 430 (pediatric cases)Demographic, clinical, and biochemical dataSLIM risk modelAUC: 0.850; AUPR: 0.900
36Hayashi et al[55]2021JapanAAp: 70 videos (pediatric cases)70 videos (between 85-347 images per video)U-net-based CNNNot indicated
37Reismann et al[56]2021GermanyAAp: 29Gene expression data (56.666 gene)LR-based biomarker signature (4 genes)AUC: 0.84
38Ghareeb et al[54]2021Egypt319Clinical findings. Chronic diseases. Patient characteristics. Laboratory and imagingEnsemble model (subspace KNN)AUC: 0.82; accuracy: 91.1
39Stiel et al[57]2020GermanyCompl AAp: 102; uncompl AAp: 234; negative AAp: 12; non-AAp: 115 (pediatric cases)Demographic, clinical, biochemical and radiological dataModified HAS based CART, AI score based RF (AAp vs nonoperative)Sensitivity: 86.6; specificity: 70.9; AUC: 0.920
Modified HAS based CART, AI score based RF (uncompl vs compl AAp)Sensitivity: 97.1; specificity: 17.9; AUC: 0.710
40Akmese et al[58]2020TurkeyAAp: 214; non-AAp: 214Demographic and biochemical dataRF, CART, SVM, LR, KNN, ANN, GB (GB best results)Accuracy: 95.3; sensitivity: 93.2; specificity: 97.1
41Aydin et al[59]2020TurkeyControl: 4244; negative AAp: 169; compl AAp: 1559; uncompl AAp: 1272 (pediatric cases)Demographic and biochemical dataKNN, NB, DT, SVM, GLM, RF (RF best results)Accuracy: 97.5; sensitivity: 97.8; specificity: 97.2; AUC: 0.997
42Rajpurkar et al[60]2020United StatesAAp: 359; non-AAp: 287CT imagesAverage of 2D Res-Net18, average of 2D Res-Net34, LRCN Res-Net18, LRCN Res-Net34, SE-ResNeXt-50, AppendiXNet (3D-ResNet CNN)Accuracy: 72.5; sensitivity: 78.4; specificity: 66.7; AUC: 0.810
43Park et al[61]2020United StatesAAp: 215; non-AAp: 452CT images3D-CNN + grad-CAMAccuracy: 91.5; sensitivity: 90.2; specificity: 92.0
44Zhao et al[63]2020ChinaAAp: 48; non-AAp: 86Midstream urine samplesUrinary proteomics + RF, SVM, NB (RF best results)Accuracy: 83.6; sensitivity: 81.2; specificity: 84.4
45Ramirez-garcialuna et al[62]2020MexicoAAp: 51; non-AAp: 17; negative AAp: 3; control: 51Demographic, clinical biochemical, radiological and infrared thermal dataInfrared thermography + RF classifierAccuracy: 92.3; sensitivity: 90.0; specificity: 96.1; AUC: 0.906
46Reismann et al[65]2019GermanyCompl AAp: 183; uncompl AAp: 290; negative AAp: 117 (pediatric cases)Signature appendiceal diameter CRP leukocytes neutrophilsCRP, leukocytes, neutrophils, linear model (LBFGS) (AAp vs non-AAp)Accuracy: 90.0; sensitivity: 93.0; specificity: 67.0; AUC: 0.910
CRP, leukocytes, neutrophils, linear model (LBFGS) (compl vs uncompl AAp)Accuracy: 51.0; sensitivity: 95.0; specificity: 33.0; AUC: 0.800
47Kang et al[64]2019South KoreaAAp: 80; non-AAp: 164Demographic, clinical biochemical and radiological dataAlvarado, AAS, Eskelinen, DT based CHAID algorithmAUC: 0.850
48Gudelis et al[66]2019SpainAAp: 93; non-AAp: 159Demographic, clinical biochemical and radiological dataANNAUC: 0.950; PCC: 93.5
CHAIDAUC: 0.930; PCC: 81.7
49Shahmoradi et al[67]2018IranAAp: 133; negative AAp: 48Demographic, clinical and biochemical dataMLPAccuracy: 92.9; sensitivity: 80.0; specificity: 97.5; AUC: 0.832
RBFNAccuracy: 77.6; sensitivity: 28.0; specificity: 87.8
LRAccuracy: 83.9; sensitivity: 58.3; specificity: 93.2; AUC: 0.808
50Jamshidnezhad et al[69]2017IranNADemographic, clinical biochemical and radiological dataACSS, MLNN, SVM, NN, hybrid fuzzy model, evolutionary–fuzzy + HBRCAccuracy: 89.9
51Afshari Safavi et al[68]2015IranCompl AAp: 24; uncompl: 59; negative AAp: 17Demographic, and biochemical dataANN (MLP)Accuracy: 88.0; sensitivity: 97.6; AUC: 0.875
52Park and Kim[70]2015South KoreaCompl AAp: 62; uncompl AAp: 143; non-AAp: 596Demographic, clinical and radiological dataMLNNAccuracy: 97.8; sensitivity: 96.6; specificity: 99.5
RBFAUC: 99.8; sensitivity: 99.7; specificity: 100
PNNAUC: 99.4; sensitivity: 98.1; specificity: 100
53Lee et al[75]2013TaiwanAAp: 464; negative-AAp: 110Demographic, clinical and biochemical dataPEL, SVM, SMOTE, MCC, CM, WCUS, Alvarado (PEL best results)Sensitivity: 57.3; specificity: 66.7; AUC: 0.619
54Iliou et al[94]2013GreeceAAp: 71 Non-AAp: 236 (pediatric cases)Demographic, clinical and biochemical dataK1, JRip, bagging ensemble (majority voting)Accuracy: 87.8
55Deleger et al[95]2013United StatesAAp: 534; control: 1566Components of the pediatric appendicitis scoreNLPSensitivity: 86.9; precision: 86.8; specificity: 93.8
56Yoldaş et al[71]2012TurkeyAAp: 132; negative-AAp: 24Demographic, clinical and biochemical dataANNSensitivity: 100; specificity: 97.2; AUC: 0.950
57Son et al[76]2012South KoreaAAp: 152; non-AAp: 174Demographic, clinical and biochemical dataDT C5.0 model (univariate)Accuracy: 80.2; sensitivity: 82.4; specificity: 78.3; AUC: 0.803
DT C5.0 model (multivariate)Accuracy: 73.5; sensitivity: 66.0; specificity: 80.0; AUC: 0.730
58Malley et al[96]2012United StatesAAp: 85; negative AAp: 21Biochemical datab-NN, class RF, Iboost, LR, KNN, regRF (regRF best results)Brier score: 0.061; AUC: 0.976
59Grigull and Lechner[74]2012GermanyAAp: 45 (pediatric cases)Demographic, clinical and biochemical dataSVM, ANN, fuzzy logic, voting algorithm (combination best results)Accuracy: 97.4
60Hsieh et al[72]2011TaiwanCompl AAp: 28; uncompl AAp: 87; negative AAp: 11; non-AAp: 65Demographic, clinical and biochemical dataRF, SVM, ANN, LR (RF best results)Accuracy: 96.0; sensitivity: 94.0; specificity: 100; AUC: 0.980
61Ting et al[77]2010TaiwanCompl AAp: 80; uncompl: 340; negative-AAp: 112Demographic, clinical and biochemical dataDTSensitivity: 94.5; specificity: 80.5
62Prabhudesai et al[73]2008United KingdomAAp: 24; non-AAp: 36Demographic, clinical and biochemical dataAlvarado (≥ 7), Alvarado (≥ 6), clinical, ANN (ANN best results)Sensitivity: 100; specificity: 97.2; PPV: 96.0; NPV: 100
63Sakai et al[78]2007JapanAAp: 86; negative AAp: 12; non-AAp: 71Demographic, clinical and biochemical dataLRSensitivity: 21.4; specificity: 80.4; AUC: 0.719
ANNSensitivity: 19.9; specificity: 78.5; AUC: 0.741
64Pesonen et al[98]1996FinlandSuspected AAp: 911Demographic, clinical and biochemical dataNN (ART1)Sensitivity: 79.0; specificity: 78.0
NN (SOM)Sensitivity: 55.0; specificity: 83.0
NN (LVQ)Sensitivity: 87.0; specificity: 90.0
NN (BP)Sensitivity: 83.0; specificity: 92.0
65Forsström et al[97]1995FinlandAAp: 145; negative AAp: 41Biochemical dataLRAUC: 0.678
DiagaiDAUC: 0.683
NN (BP)AUC: 0.622


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