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Brenac et al. Art Int Surg 2024;4:296-315   https://dx.doi.org/10.20517/ais.2024.49                                                                                                                                                       Page 306



                                                                                                                                                                   (2) Patients reported a greater perceived age reduction
                                                                                                                                                                   (-6.7 years) compared to the neural network estimates
                                                                                                                                                                   (-4.3 years)
                                                                                                                                                                   (3) FACE-Q scores indicated high patient satisfaction
                                                                                                                                                                   with facial appearance, quality of life, and overall
                                                                                                                                                                   outcome
                                                                                                                                                                   (4) A positive correlation was found between neural
                                                                                                                                                                   network age reduction estimates and patient satisfaction
                                              Boonipat       Using artificial intelligence to   2020 Plastic and     (1) Evaluate the use of ML to measure facial   (1) The facial recognition application showed a greater
                                               et al. [40]   measure facial expression following    Reconstructive   expression before and after facial reanimation   recognition of happy signals in postoperative (42%) vs.
                                                             facial reanimation surgery             Surgery          surgery using video data                      preoperative (13%) smile videos (P < 0.0001) compared
                                                                                                                                                                   to 53% in control videos
                                                         [41]
                                              Geisler et al.  A role for artificial intelligence in   2021 Journal of   (1) Develop CNN models based on the ResNet-50  (1) CNN model developed showed an overall testing
                                                             the classification of craniofacial     Craniofacial     architecture to classify non-syndromic CS from 2D  accuracy of 90.6%, demonstrating the potential of ML to
                                                             anomalies                              Surgery          clinical photographs                          detect craniofacial conditions
                                              Knoops         A machine learning framework for   2019 Scientific Reports  (1) Develop the first fully automated large-scale   (1) The developed 3DMM achieves a diagnostic
                                                   [42]
                                               et al.        automated diagnosis and                                 clinical 3DMM for supervised learning in      sensitivity of 95.5% and specificity of 95.2%
                                                             computer-assisted planning in                           diagnostics, risk stratification, and treatment   (2) The model simulates surgical outcomes with a mean
                                                             plastic and reconstructive surgery                      simulation, and to demonstrate its potential for   accuracy of 1.1 ± 0.3 mm
                                                                                                                     improving clinical decision making in orthognathic  (3) The 3DMM framework automates diagnosis and
                                                                                                                     surgery                                       provides patient-specific treatment plans from 3D scans,
                                                                                                                                                                   improving efficiency in clinical decision making
                                                      [44]
                                              Lim et al.     Using generative artificial      2023 Journal of Clinical   (1) Investigating the capacity of AI tools to   (1) DALL-E-2, Midjournet and Blue Willow showed a
                                                             intelligence tools in cosmetic         Medicine         generate realistic images pertinent to cosmetic   higher representation of females, light skin tones, and
                                                             surgery: a study on rhinoplasty,                        surgery                                       with a BMI < 20
                                                             facelifts, and blepharoplasty                                                                         (2) AI tools could enhance patient information but must
                                                             procedures                                                                                            be integrated ethically to ensure comprehensive
                                                                                                                                                                   representation and maintain medical standards
                          Hand surgery        Ozkaya         Evaluation of an artificial      2022 European Journal of  (1) Determine the diagnostic performance of ML to  (1) ML demonstrated 76% sensitivity, 92% specificity,
                                                   [46]
                                               et al.        intelligence system for diagnosing     Trauma and       detect scaphoid fractures on anteroposterior wrist  an AUC of 0.840, a Youden index of 0.680, and an F-
                                                             scaphoid fracture on direct            Emergency Surgery radiographs                                  score of 0.826 for detecting scaphoid fractures
                                                             radiography                                                                                           (2) The experienced orthopedic specialist had the
                                                                                                                                                                   highest diagnostic performance based on AUC, while ML
                                                                                                                                                                   performance was comparable to that of a less
                                                                                                                                                                   experienced orthopedic specialist and superior to the ED
                                                                                                                                                                   physician
                                                         [47]
                                              Oeding et al.  Diagnostic performance of artificial  2024 The Journal of   (1) Determine the diagnostic efficacy of AI models   (1) AI models exhibited strong diagnostic performance,
                                                             intelligence for detection of          Hand Surgery     for detecting scaphoid and distal radius fractures   with AUROC values ranging from 0.77 to 0.96 for
                                                             scaphoid and distal radius                              (2) Compare the efficacy to human clinical experts  scaphoid fractures and 0.90 to 0.99 for distal radius
                                                             fractures: a systematic review                                                                        fractures. Accuracy ranged from 72.0% to 90.3% for
                                                                                                                                                                   scaphoid fractures and 89.0% to 98.0% for distal radius
                                                                                                                                                                   fractures
                                                                                                                                                                   (2) Compared to clinical experts, 92.9% of the studies
                                                                                                                                                                   found AI models to have comparable or better
                                                                                                                                                                   performance. AI models generally showed poorer
                                                                                                                                                                   performance on occult scaphoid fractures, though
                                                                                                                                                                   models specifically trained for these types of fractures
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