Evidence-Based Medicine

Research Appraisals

Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.

Showing 3 appraisals

Systematic ReviewEvidence: Weak
40CEBM

International journal of medical informatics

Beyond the conventional: Artificial intelligence in identifying risk factors in sports injuries. A scoping review.

PURPOSE: To map contemporary uses of artificial intelligence (AI) to identify conventional and unconventional risk factors for sports injuries in athletes. METHODS: Following Joanna Briggs Institute guidance and PRISMA-ScR, we conducted an open-access search (January 2015-September 2025) in PubMed/MEDLINE, Scopus, and ScienceDirect using MeSH/DeCS terms for AI and injury risk. Records were managed in Rayyan with de-duplication, independent triple screening, standardized data extraction, and narrative synthesis to address heterogeneity. RESULTS: Fifty-nine studies met inclusion criteria. Frequently modelled predictors included sleep quality and psychological state, external and internal load metrics, and prior injury. AI approaches spanned classical machine learning and deep learning applied to multimodal sensor and clinical data. Across studies, generalizability was limited by heterogeneous populations, outcomes, and measurement/reporting practices; few works reported consistent measurement standards or external validation. Where assessed, observer agreement and classification performance were acceptable but variable. CONCLUSION: AI for sports-injury risk is expanding rapidly, led by classical machine learning on multimodal sensor data. Key gaps are external validity and reproducibility. Progress will require multicenter prospective cohorts, standardized measurement and reporting, sport-specific meta-analyses, transparent model sharing, and deliberate clinical integration into athlete care pathways.

4 July 2026

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Systematic ReviewEvidence: Weak
25CEBM

Neuroscience and biobehavioral reviews

Anxiety detection using neural and physiological signals and artificial intelligence: A comprehensive review.

Anxiety disorders are a significant challenge to global health, yet current diagnostic methods rely mainly on subjective and episodic assessment. The application of artificial intelligence (AI) in combination with neural and physiological signals is a promising pathway toward objective and continuous monitoring. This review provides a comprehensive evaluation of machine learning (ML) and deep learning (DL) techniques applied to electroencephalography (EEG), electrocardiography (ECG), Photoplethysmography (PPG), and electrodermal activity (EDA) for anxiety detection. A systematic review of the literature covering the period 2015-2025 indicates that the field has evolved from traditional ML systems based on hand-crafted features to modern end-to-end deep learning schemes. Our review indicates that while classical models remain effective, hybrid models such as CNN-LSTM and more sophisticated architectures, like Transformers, consistently deliver state-of-the-art results, particularly in multimodal data integration scenarios. Despite the impressive accuracies reported, a critical examination identifies several key challenges including reliance on narrow, laboratory-trained datasets, a lack of standardized validation procedures, and limited transparency in complex models, collectively impeding clinical translation. Progress in this field requires the creation of large-scale, clinically-validated datasets; the development of fault-tolerant, generalizable, and interpretable schemes; and a transition from basic state classification towards longitudinal, personalized monitoring in support of just-in-time intervention. As a comprehensive and up-to-date narrative synthesis of AI-driven anxiety detection using neural and physiological signals, this review consolidates a fragmented literature, articulates the translational gaps limiting real-world deployment, and establishes a clear research agenda for the development of clinically impactful digital mental health technologies.

3 July 2026

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Systematic ReviewEvidence: Weak
60CEBM

European respiratory review : an official journal of the European Respiratory Society

Cough biomarkers for diagnosis and monitoring of respiratory disease: a systematic review

Cough is a common and physiologically informative component of respiratory morbidity, but its potential for diagnosing and monitoring disease is not thoroughly investigated. This systematic review synthesised the literature on algorithmic and statistical models analysing cough acoustics for diagnosing or monitoring respiratory conditions. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, five databases (PubMed, Embase, Scopus, Web of Science and CENTRAL) were systematically searched for studies published from January 2010 to June 2025. Eligible studies performed quantitative acoustic feature analysis of human coughs using statistical, machine learning or deep learning models and reported diagnostic or prognostic performance. 89 studies from 34 countries were assessed, covering cough detection (n=31), disease classification (n=55) and disease severity prediction (n=3), reflecting potential applications in disease monitoring. Deep learning approaches, especially convolutional and recurrent networks, were predominant (n=56) and tended to achieve the higher accuracies, although machine learning ensemble methods and logistic regression also demonstrated strong performance, particularly with well-engineered features. Across different diseases, sensitivities and specificities were often reported to be ≥90%, notably for tuberculosis, asthma and COVID-19. However, methodological weaknesses were common, with only 11.2% of studies introducing external validation, 71.1-87.6% demonstrating high risk of bias (according to PROBAST-AI) and most based on small, homogeneous or crowdsourced cohorts with limited generalisability. These limitations contribute to inflated internal performance and uncertainty about real-world applicability. Cough acoustic biomarkers hold promise as an adjunctive tool for screening and longitudinal monitoring in low-resource environments. Nevertheless, widespread implementation will require large, multicentre validation, standardised calibration, bias control and incorporation into privacy-preserving workflows.

25 June 2026

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