Table 16 Comprehensive external validation performance metrics.

From: Novel metaheuristic optimized latent diffusion framework for automated oral disease detection in public health screening

Dataset

Sample size

Overall accuracy (95% CI)

Sensitivity (95% CI)

Specificity (95% CI)

PPV (95% CI)

NPV (95% CI)

AUC (95% CI)

Class imbalance ratio

Imaging quality (mean ± SD)

t-statistic

p-value

Original test

3750

97.3% (96.8–97.8)

96.8% (96.2–97.4)

97.7% (97.2–98.2)

96.2% (95.5–96.9)

98.1% (97.7–98.5)

0.993 (0.989–0.997)

1:1.8 (balanced)

4.7 ± 0.3

ExtVal-1 (rural)

12,400

89.4% (88.7–90.1)

87.2% (86.3–88.1)

91.1% (90.4–91.8)

84.7% (83.6–85.8)

92.8% (92.2–93.4)

0.947 (0.941–0.953)

1:47.3 (severe)

2.9 ± 0.8

-12.34

< 0.001

ExtVal-2 (urban)

18,600

91.7% (91.2–92.2)

89.8% (89.1–90.5)

93.2% (92.7–93.7)

88.4% (87.6–89.2)

94.1% (93.7–94.5)

0.964 (0.960–0.968)

1:18.6 (high)

3.4 ± 0.6

-9.87

< 0.001

ExtVal-3 (mobile)

9800

86.2% (85.3–87.1)

83.9% (82.8–85.0)

88.1% (87.2–89.0)

81.3% (80.1–82.5)

89.7% (88.9–90.5)

0.921 (0.914–0.928)

1:62.1 (extreme)

2.1 ± 0.9

-15.67

< 0.001

ExtVal-4 (international)

14,200

88.9% (88.3–89.5)

86.7% (85.9–87.5)

90.8% (90.2–91.4)

85.2% (84.3–86.1)

91.4% (90.9–91.9)

0.951 (0.946–0.956)

1:23.4 (high)

3.2 ± 0.7

-11.42

< 0.001

ExtVal-5 (early pathology)

7300

84.6% (83.6–85.6)

81.2% (79.9–82.5)

87.3% (86.2–88.4)

78.9% (77.4–80.4)

88.8% (87.8–89.8)

0.912 (0.904–0.920)

1:156.7 (extreme)

4.1 ± 0.5

-18.23

< 0.001

ExtVal-6 (emergency)

11,100

82.3% (81.5–83.1)

79.8% (78.7–80.9)

84.2% (83.3–85.1)

76.4% (75.2–77.6)

86.1% (85.3–86.9)

0.895 (0.887–0.903)

1:34.2 (severe)

2.3 ± 1.1

-19.84

< 0.001

ExtVal-7 (longitudinal)

8900

90.8% (90.1–91.5)

88.4% (87.5–89.3)

92.7% (92.0-93.4)

87.1% (86.1–88.1)

93.2% (92.6–93.8)

0.958 (0.952–0.964)

1:15.2 (moderate)

3.8 ± 0.4

-8.76

< 0.001

External average

82,300

87.7% (87.4–88.0)

85.3% (84.9–85.7)

89.6% (89.3–89.9)

83.1% (82.6–83.6)

90.9% (90.6–91.2)

0.935 (0.932–0.938)

1:39.6

3.1 ± 0.7

-13.45

< 0.001