Diagnostic value of real-time computer-aided detection for precancerous lesion during esophagogastroduodenoscopy: A meta-analysis

Table 3 Subgroup analysis of diagnostic effect

Subgroup	No. studies	No. patients	Sensitivity (AI-CAD)			Specificity (AI-CAD)			Sensitivity (endoscopist)			Specificity (endoscopist)			Difference of accuracy			Difference of log (DOR)
			Value	I2 (%)	P value	Value	I2 (%)	P value	Value	I2 (%)	P value	Value	I2 (%)	P value	Value	I2 (%)	P value	Value	I2 (%)	P value
Race
Asian	5	1667	0.890 (95%CI: 0.837-0.928)	53.0	0.070	0.930 (95%CI: 0.891-0.956)	70.8	0.009	0.658 (95%CI: 0.618-0.696)	43.9	0.039	0.810 (95%CI: 0.723-0.874)	75.3	0.001	0.167 (95%CI: 0.112-0.221)	22.9	0.118	-0.355 (95%CI: -1.110 to 0.401)	9.3	0.296
Others	5	446	0.896 (95%CI: 0.821-0.942)	49.9	0.083	0.831 (95%CI: 0.746-0.891)	16.3	0.276	0.703 (95%CI: 0.632-0.766)	0.0	0.746	0.721 (95%CI: 0.608-0.812)	76.1	0.002	0.142 (95%CI: 0.072-0.211)	64.8	0.022	0.151 (95%CI: -0.805 to 1.107)	62.6	0.032
Number of patients
< 100	5	392	0.895 (95%CI: 0.819-0.941)	49.2	0.089	0.842 (95%CI: 0.741-0.909)	31.4	0.242	0.731 (95%CI: 0.660-0.791)	17.6	0.235	0.703 (95%CI: 0.594-0.793)	64.0	0.027	0.147 (95%CI: 0.074-0.220)	60.2	0.041	0.213 (95%CI: -0.756 to 1.182)	60.3	0.035
≥ 100	5	1721	0.891 (95%CI: 0.838-0.928)	54.0	0.066	0.922 (95%CI: 0.870-0.954)	83.1	0.000	0.650 (95%CI: 0.614-0.684)	6.7	0.432	0.816 (95%CI: 0.742-0.872)	78.8	0.000	0.163 (95%CI: 0.106-0.219)	66.1	0.037	-0.387 (95%CI: -1.112 to 0.339)	3.4	0.306
Study design
Paired	2	1200	0.868 (95%CI: 0.783-0.923)	71.1	0.063	0.944 (95%CI: 0.879-0.975)	90.4	0.001	0.650 (95%CI: 0.586-0.710)	33.8	0.219	0.766 (95%CI: 0.600-0.877)	91.1	0.001	0.196 (95%CI: 0.125-0.266)	0.0	0.378	-0.774 (95%CI: -1.475 to -0.073)	0.0	0.536
Others	8	913	0.904 (95%CI: 0.856-0.937)	44.0	0.116	0.868 (95%CI: 0.803-0.913)	57.7	0.018	0.694 (95%CI: 0.640-0.743)	30.1	0.159	0.773 (95%CI: 0.684-0.842)	75.2	0.000	0.141 (95%CI: 0.092-0.189)	56.8	0.026	0.075 (95%CI: -0.542 to 0.693)	40.5	0.101
Type of lesion
BE	5	446	0.896 (95%CI: 0.821-0.942)	49.9	0.083	0.831 (95%CI: 0.746-0.891)	16.3	0.276	0.703 (95%CI: 0.632-0.766)	0.0	0.746	0.721 (95%CI: 0.608-0.812)	76.1	0.002	0.142 (95%CI: 0.072-0.211)	64.8	0.022	0.151 (95%CI: -0.805 to 1.107)	62.6	0.032
Others	5	1667	0.890 (95%CI: 0.837-0.928)	53.0	0.070	0.930 (95%CI: 0.891-0.956)	70.8	0.009	0.658 (95%CI: 0.618-0.696)	43.9	0.039	0.810 (95%CI: 0.723-0.874)	75.3	0.001	0.167 (95%CI: 0.112-0.221)	22.9	0.118	-0.355 (95%CI: -1.110 to 0.401)	9.3	0.296
Imaging modality
WLE	4	931	0.906 (95%CI: 0.835-0.949)	63.0	0.025	0.935 (95%CI: 0.877-0.967)	59.7	0.044	0.662 (95%CI: 0.596-0.722)	26.1	0.255	0.764 (95%CI: 0.634-0.858)	88.1	0.000	0.202 (95%CI: 0.134-0.269)	0.1	0.438	0.560 (95%CI: -0.458 to 1.579)	65.3	0.020
Others	6	1182	0.886 (95%CI: 0.827-0.926)	26.8	0.253	0.861 (95%CI: 0.790-0.911)	73.1	0.002	0.685 (95%CI: 0.630-0.735)	31.3	0.127	0.775 (95%CI: 0.679-0.849)	66.3	0.007	0.128 (95%CI: 0.074-0.183)	69.1	0.005	-0.530 (95%CI: -1.261 to 0.201)	0.9	0.536
AI model for segmentation
U-Net	4	1587	0.887 (95%CI: 0.828-0.927)	59.7	0.048	0.939 (95%CI: 0.904-0.961)	69.1	0.015	0.648 (95%CI: 0.611-0.682)	11.0	0.323	0.810 (95%CI: 0.710-0.881)	83.2	0.000	0.187 (95%CI: 0.155-0.220)	0.0	0.735	-0.376 (95%CI: -1.170 to 0.418)	17.4	0.187
Others	6	526	0.900 (95%CI: 0.835-0.941)	43.6	0.119	0.834 (95%CI: 0.765-0.886)	7.3	0.358	0.724 (95%CI: 0.660-0.779)	0.0	0.327	0.737 (95%CI: 0.632-0.820)	72.4	0.002	0.118 (95%CI: 0.069-0.167)	63.1	0.021	0.093 (95%CI: -0.783 to 0.970)	52.1	0.060

WLE: White light endoscopy; AI-CAD: Artificial intelligence-enhanced real-time computer-aided detection systems; DOR: Diagnostic odds ratio; BE: Barrett's esophagus; AI: Artificial intelligence.