Fig. 1: Eligibility criteria.

The flow diagram illustrates the systematic review process, starting with 18,371 initial records identified from multiple databases: 4017 from MEDLINE, 4780 from Scopus, 8501 from Web of Science, 863 from CENTRAL, and 210 from medRxiv. After removing 10,357 duplicates, 8014 records were screened. Of these, 7795 were excluded as they did not align with the objectives of this systematic review, leaving 219 full-text articles for eligibility assessment. Further evaluation resulted in 143 exclusions due to various reasons: 129 articles without diagnostic accuracy, 6 with unknown sample size, 3 preprints of already published peer-reviewed papers, 2 not using generative artificial intelligence, 1 article about examination problems, 1 about students, and 1 about study protocol without results. Seven additional articles were identified through other sources including web search, resulting in a final total of 83 articles included in the systematic review and meta-analysis focusing on generative AI models.