Artificial intelligence in prognostication and treatment response modeling in advanced hepatocellular carcinoma

Table 5 Major methodological limitations in current artificial intelligence-hepatocellular carcinoma studies

Domain	Specific limitation	Consequence
Statistical design	High-dimensional feature space with low event count	Model instability, optimism bias
Validation	Limited external and temporal validation	Poor transportability
Causal modeling	Lack of treatment-effect estimation frameworks	Prognostic misinterpreted as predictive
Radiomics	Scanner variability, segmentation inconsistency	Reduced reproducibility
Calibration	Rarely reported	Poor absolute risk estimation
Clinical utility	No decision curve or impact analysis	Uncertain real-world benefit