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人工智能诊断浅表真菌感染:范围综述

J Fungi (Basel) · 2026年9月11日 · Denisa Mihaela Loghin Misăiloaie 等 5 位作者

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一分钟了解要点综述发现该领域验证不足,尚难进入临床常规。结果研究集中在读片和影像环节,整合判断环节完全空白;多数只做了单中心内部验证,只有一项完成外部验证,仅少数公开代码和数据,约一半未报告人群信息,利益冲突集中在独立验证最少的分子诊断领域,重评后准确率明显下降(曲线下面积从 0.98 降到 0.75)。

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Artificial intelligence (AI) is increasingly proposed for diagnosing superficial mycoses, yet whether this literature covers the diagnostic pathway evenly, and is mature enough for clinical translation, remains unclear. We mapped AI applications onto an operational partition of the diagnostic pathway (D1-D4), a construct of this review: pre-analytical clinician-facing imaging (D1), analytical microscopy and histopathology (D2), analytical molecular identification (D3) and integrative post-analytical interpretation (D4). Thirty-three primary studies (2007 to 2026) were included, 85% published since 2021 and predominantly from Asia. Applications concentrated on D2 (n = 16) and D1 (n = 13), with few in D3 (n = 4) and none in D4. Reported accuracy was frequently high but rested on internal, single-centre validation: complete external validation and prospective preregistration were each present in a single study, only a handful shared both public code and public data, about half reported no demographic data and no D1 study stratified performance by Fitzpatrick phototype. A substantial minority carried conflicts of interest tied to the evaluated tool, concentrated in the molecular domain where independent verification was scarcest; where such re-evaluation was possible, reported accuracy fell markedly (one area under the curve (AUC) from 0.98 to 0.75). This corpus is skewed toward the early diagnostic steps, leaves the integrative post-analytical step unaddressed and shows methodological maturity insufficient for routine clinical translation. Institutionalised external validation, reproducibility through open code and data, declaration of dataset overlap and conflicts of interest, and clinically meaningful outcomes are the priorities for future work.

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