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Original research
Reporting quality of studies using machine learning models for medical diagnosis: a systematic review
  1. Mohamed Yusuf1,
  2. Ignacio Atal2,3,
  3. Jacques Li3,
  4. Philip Smith1,
  5. Philippe Ravaud3,
  6. Martin Fergie4,
  7. Michael Callaghan1,
  8. James Selfe1
  1. 1Health Professions, Manchester Metropolitan University, Manchester, UK
  2. 2Centre for Research and Interdisciplinarity (CRI), Université Paris Descartes, Paris, Île-de-France, France
  3. 3U1153, Epidemiology and Biostatistics Sorbonne Paris Cite Research Center (CRESS), Methods of therapeutic evaluation of chronic diseases team (METHODS), INSERM, Université Paris Descartes, Paris, Île-de-France, France
  4. 4Imaging and Data Sciences, The University of Manchester, Manchester, UK
  1. Correspondence to Dr Mohamed Yusuf; m.yusuf{at}


Aims We conducted a systematic review assessing the reporting quality of studies validating models based on machine learning (ML) for clinical diagnosis, with a specific focus on the reporting of information concerning the participants on which the diagnostic task was evaluated on.

Method Medline Core Clinical Journals were searched for studies published between July 2015 and July 2018. Two reviewers independently screened the retrieved articles, a third reviewer resolved any discrepancies. An extraction list was developed from the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis guideline. Two reviewers independently extracted the data from the eligible articles. Third and fourth reviewers checked, verified the extracted data as well as resolved any discrepancies between the reviewers.

Results The search results yielded 161 papers, of which 28 conformed to the eligibility criteria. Detail of data source was reported in 24 of the 28 papers. For all of the papers, the set of patients on which the ML-based diagnostic system was evaluated was partitioned from a larger dataset, and the method for deriving such set was always reported. Information on the diagnostic/non-diagnostic classification was reported well (23/28). The least reported items were the use of reporting guideline (0/28), distribution of disease severity (8/28 patient flow diagram (10/28) and distribution of alternative diagnosis (10/28). A large proportion of studies (23/28) had a delay between the conduct of the reference standard and ML tests, while one study did not and four studies were unclear. For 15 studies, it was unclear whether the evaluation group corresponded to the setting in which the ML test will be applied to.

Conclusion All studies in this review failed to use reporting guidelines, and a large proportion of them lacked adequate detail on participants, making it difficult to replicate, assess and interpret study findings.

PROSPERO registration number CRD42018099167.

  • machine learning
  • medical diagnosis
  • clinical prediction
  • reporting quality

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors JS is a guarantor of this review. All authors have made substantive intellectual contributions to the development of this review. MY and IA were involved in conceptualising the review. MY, IA and PR developed the protocol. MY, JL and IA did the literature search, MY, JL, PS and IA carried out the study selection and data extraction. MY, IA, JS, PS, MF and MC were involved in the writing and editing of the manuscript.

  • Funding This review was conducted independently by the research team.

  • Disclaimer There is no funding attached to this systematic review.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. All data are freely available within the appendices. No additional available.

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