Findings

What do systematic reviews say?

1,036 questions · 1,100 findings · 261 reviews

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No studies found 160 · 14.5%GRADE not reported 188 · 17.1%Very low 270 · 24.5%Low 303 · 27.5%Moderate 139 · 12.6%High 40 · 3.6%

Continuous CTG vs intermittent auscultation

Neonatal seizures · Pregnant women undergoing fetal assessment during labour

Continuous CTG probably leads to lower neonatal seizures compared with intermittent auscultation (moderate certainty).

1 finding from 1 review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour 2017 · Cochrane Headline outcomes only
RR 0.5 [0.31, 0.8]
9 studies · 32386 participants
Moderate

Continuous CTG vs intermittent auscultation

Cerebral palsy · Pregnant women undergoing fetal assessment during labour

Continuous CTG showed no clear difference in cerebral palsy compared with intermittent auscultation (low certainty).

1 finding from 1 review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour 2017 · Cochrane Headline outcomes only
RR 1.75 [0.84, 3.63]
2 studies · 13252 participants
Low

Continuous CTG vs intermittent auscultation

Caesarean section · Pregnant women undergoing fetal assessment during labour

Continuous CTG may leads to higher caesarean section compared with intermittent auscultation (low certainty).

1 finding from 1 review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour 2017 · Cochrane Headline outcomes only
RR 1.63 [1.29, 2.07]
11 studies · 18861 participants
Low

Continuous CTG vs intermittent auscultation

Instrumental vaginal birth · Pregnant women undergoing fetal assessment during labour

Continuous CTG may leads to higher instrumental vaginal birth compared with intermittent auscultation (low certainty).

1 finding from 1 review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour 2017 · Cochrane Headline outcomes only
RR 1.15 [1.01, 1.33]
10 studies · 18615 participants
Low

Continuous CTG vs intermittent auscultation

Cord blood acidosis · Pregnant women undergoing fetal assessment during labour

It is very uncertain whether continuous CTG changes cord blood acidosis compared with intermittent auscultation (very low certainty).

1 finding from 1 review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour 2017 · Cochrane Headline outcomes only
RR 0.92 [0.27, 3.11]
2 studies · 2494 participants
Very low

Continuous CTG vs intermittent auscultation

Use of pharmacological analgesia · Pregnant women undergoing fetal assessment during labour

Continuous CTG showed no clear difference in any pharmacological analgesia compared with intermittent auscultation (low certainty).

1 finding from 1 review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour 2017 · Cochrane Headline outcomes only
RR 0.98 [0.88, 1.09]
3 studies · 1677 participants
Low

Routine/revealed vs selective/concealed ultrasound

Detection of fetal abnormality before 24 weeks' gestation · Fetal ultrasound assessment before 24 weeks' gestation

Routine/revealed probably leads to higher detection of fetal abnormality before 24 weeks' gestation compared with selective/concealed ultrasound (moderate certainty).

1 finding from 1 review

Ultrasound for fetal assessment in early pregnancy 2015 · Cochrane Headline outcomes only
RR 3.46 [1.67, 7.14]
2 studies · 387 participants
Moderate

Routine/revealed vs selective/concealed ultrasound

Detection of multiple pregnancy by 24 to 26 weeks' gestation (number NOT detected) · Fetal ultrasound assessment before 24 weeks' gestation

Routine/revealed probably leads to lower detection of multiple pregnancy by 24 to 26 weeks' gestation (number… compared with selective/concealed ultrasound (moderate certainty).

1 finding from 1 review

Ultrasound for fetal assessment in early pregnancy 2015 · Cochrane Headline outcomes only
RR 0.07 [0.03, 0.17]
7 studies · 295 participants
Moderate

Routine/revealed vs selective/concealed ultrasound

Induction of labour for post‐maturity · Fetal ultrasound assessment before 24 weeks' gestation

Routine/revealed may leads to lower induction of labour for 'post‐term' pregnancy compared with selective/concealed ultrasound (low certainty).

1 finding from 1 review

Ultrasound for fetal assessment in early pregnancy 2015 · Cochrane Headline outcomes only
RR 0.59 [0.42, 0.83]
8 studies · 25516 participants
Low

Routine/revealed vs selective/concealed ultrasound

Perinatal mortality · Fetal ultrasound assessment before 24 weeks' gestation

Routine/revealed showed no clear difference in perinatal death (all babies) compared with selective/concealed ultrasound (low certainty).

1 finding from 1 review

Ultrasound for fetal assessment in early pregnancy 2015 · Cochrane Headline outcomes only
RR 0.89 [0.7, 1.12]
10 studies · 35735 participants
Low

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Sensitivity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled sensitivity (0.85) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%) and evidence of publication bias.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
Sensitivity 0.85 [0.83, 0.93]
20 studies · 29423 participants
GRADE not reported

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative post-test probability · Dental images or diagnostic tests for dental caries detection

The negative post-test probability was 6%; certainty was not graded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Dental imaging across modalities · Overall (all imaging modalities pooled)
Post-test probability 0.06
20 studies
GRADE not reported

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Specificity · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms have high pooled specificity (0.90) for detecting dental caries; ungraded, with very high heterogeneity (I2>95%).

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
Specificity 0.90 [0.85, 0.95]
20 studies · 29423 participants
GRADE not reported

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Area under the summary ROC curve · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

The area under the summary ROC curve for AI caries detection is 0.86, indicating high overall diagnostic accuracy; ungraded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
AUC 0.86
20 studies · 29423 participants
GRADE not reported

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive post-test probability · Dental images or diagnostic tests for dental caries detection

The positive post-test probability was 79%; certainty was not graded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Dental imaging across modalities · Overall (all imaging modalities pooled)
Post-test probability 0.79
20 studies
GRADE not reported

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Positive likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A positive AI test raises caries probability substantially (LR+ 10.44; positive post-test probability 79%); ungraded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
LR+ 10.443 [7.505, 14.531]
20 studies · 29423 participants
GRADE not reported

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Log diagnostic odds ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

AI algorithms show strong pooled discriminative accuracy for dental caries (log DOR 4.37; DOR 70.9); ungraded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
Log DOR 4.37 [3.16, 6.27]
20 studies · 29423 participants
GRADE not reported

AI algorithms (predominantly CNN/deep learning) as index test vs Dental expert / visual-tactile clinical assessment (reference standard)

Negative likelihood ratio · Patients undergoing dental caries detection on dental images (teeth/surfaces across imaging modalities)

A negative AI test lowers caries probability substantially (LR- 0.17; negative post-test probability 6%); ungraded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard) · Dental imaging: intraoral photographs, periapical, bitewing, panoramic radiographs, CBCT, near-infrared transillumination · Overall (all imaging modalities pooled)
LR- 0.168 [0.138, 0.205]
20 studies · 29423 participants
GRADE not reported

Machine-learning algorithms for dental caries detection vs Dental expert / visual-tactile clinical assessment (reference standard)

Diagnostic odds ratio · Dental images or diagnostic tests for dental caries detection

The pooled diagnostic odds ratio was 70.9 (95% CI 44.9 to 111.9) across 20 studies; certainty was not graded.

1 finding from 1 review

Examining the diagnostic accuracy of artificial intelligence for detecting dental caries across a range of imaging… 2025 All outcomes
Dental imaging across modalities · Overall (all imaging modalities pooled)
DOR 70.9 [44.9, 111.9]
20 studies
GRADE not reported

Teledentistry (index test): dental caries diagnosis from photographs taken with DSLR or smartphone cameras; store-and-forward vs Visual or clinical examination

Intra-examiner reliability · Children and adults with primary or permanent dentition undergoing dental caries assessment

Intra-examiner reliability ranged from kappa 0.52 to 1.00 across 6 studies; certainty not graded.

1 finding from 1 review

Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes
Cross-sectional diagnostic accuracy (index test vs reference standard, in-vivo) · In-vivo: dental clinics/hospitals, schools, and a juvenile detention facility (11 countries) · Overall (studies reporting intra-examiner reliability; narrative synthesis)
Intra-examiner reliability (kappa) reported in 6 studies, ranging from 0.52 to 1.00. No pooled estimate.
6 studies
GRADE not reported