Accuracy of machine learning models for mitral regurgitation severity assessment: A systematic review and meta-analysis

Background: Accurate assessment of mitral regurgitation (MR) severity is crucial for guiding clinical management, but is often limited by the subjectivity and variability of traditional echocardiographic evaluations. Machine learning (ML) models offer potential for automated, objective MR grading, yet their diagnostic performance remains underexplored. This systematic review and meta-analysis aim to evaluate the diagnostic accuracy of ML-based models for assessing MR severity. Methods: statistics and explored through meta-regression and subgroup analyses. Publication bias was evaluated using Deeks' test and funnel plot. Results: > 70%) was observed, partly explained by variations in validation methods and sample size. No significant publication bias was detected (Deeks' p = 0.64). The certainty of the evidence was moderate due to heterogeneity and the retrospective study design. Conclusion: ML models demonstrate good diagnostic accuracy for assessing MR severity, with the potential to enhance clinical decision-making by reducing subjectivity. However, high heterogeneity and limited external validation necessitate prospective, standardized trials to ensure generalizability and clinical adoption.