Deep learning for pneumothorax diagnosis: a systematic review and meta-analysis

BACKGROUND: Deep learning (DL), a subset of artificial intelligence (AI), has been applied to pneumothorax diagnosis to aid physician diagnosis, but no meta-analysis has been performed. METHODS: A search of multiple electronic databases through September 2022 was performed to identify studies that applied DL for pneumothorax diagnosis using imaging. Meta-analysis via a hierarchical model to calculate the summary area under the curve (AUC) and pooled sensitivity and specificity for both DL and physicians was performed. Risk of bias was assessed using a modified Prediction Model Study Risk of Bias Assessment Tool. RESULTS: In 56 of the 63 primary studies, pneumothorax was identified from chest radiography. The total AUC was 0.97 (95% CI 0.96–0.98) for both DL and physicians. The total pooled sensitivity was 84% (95% CI 79–89%) for DL and 85% (95% CI 73–92%) for physicians and the pooled specificity was 96% (95% CI 94–98%) for DL and 98% (95% CI 95–99%) for physicians. More than half of the original studies (57%) had a high risk of bias. CONCLUSIONS: Our review found the diagnostic performance of DL models was similar to that of physicians, although the majority of studies had a high risk of bias. Further pneumothorax AI research is needed.