Accuracy of artificial intelligence‐assisted detection of esophageal cancer and neoplasms on endoscopic images: A systematic review and meta‐analysis

OBJECTIVE: To investigate systematically previous studies on the accuracy of artificial intelligence (AI)‐assisted diagnostic models in detecting esophageal neoplasms on endoscopic images so as to provide scientific evidence for the effectiveness of these models. METHODS: A literature search was conducted on the PubMed, EMBASE and Cochrane Library databases for studies on the AI‐assisted detection of esophageal neoplasms on endoscopic images published up to December 2020. A bivariate mixed‐effects regression model was used to calculate the pooled diagnostic efficacy of AI‐assisted system. Subgroup analyses and meta‐regression analyses were performed to explore the sources of heterogeneity. The effectiveness of AI‐assisted models was also compared with that of the endoscopists. RESULTS: Sixteen studies were included in the systematic review and meta‐analysis. The pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio and area under the summary receiver operating characteristic curve regarding AI‐assisted detection of esophageal neoplasms were 94% (95% confidence interval [CI] 92%‐96%), 85% (95% CI 73%‐92%), 6.40 (95% CI 3.38‐12.11), 0.06 (95% CI 0.04‐0.10), 98.88 (95% CI 39.45‐247.87) and 0.97 (95% CI 0.95‐0.98), respectively. AI‐based models performed better than endoscopists in terms of the pooled sensitivity (94% [95% CI 84%‐98%] vs 82% [95% CI 77%‐86%, P < 0.01). CONCLUSIONS: The use of AI results in increased accuracy in detecting early esophageal cancer. However, most of the included studies have a retrospective study design, thus further validation with prospective trials is required.