Efficacy of Autofluorescence visualization devices in early detection of malignant transformation in Oral Potentially Malignant Disorders (OPMDs): A Systematic Review and Meta-Analysis

Background: Autofluorescence visualisation devices have emerged as promising non-invasive adjuncts to conventional oral examinations to identify subtle tissue changes indicative of dysplasia or malignancy. However, their true diagnostic efficacy in detecting malignant transformation in Oral potentially malignant disorders remains debated. Methods: A search was conducted in PubMed, Scopus, and Web of Science using terms like "oral potentially malignant disorders", "autofluorescence" and "diagnostic accuracy". Diagnostic studies evaluating autofluorescence devices for early detection of OPMDs, with histopathology as the reference standard, were included. Meta-analysis was performed using a random-effects model to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR), with heterogeneity assessed by the I² statistic. Results: Nine diagnostic accuracy studies comprising 1,262 patients were included. The pooled sensitivity of autofluorescence devices was 55.6% (95% CI: 34.6%–74.8%) and pooled specificity was 47.7% (95% CI: 29.2%–66.8%). The diagnostic odds ratio (DOR) was 1.77 (95% CI: 1.04–3.47), with substantial heterogeneity across studies (I² = 78.9%), reflecting inconsistency in diagnostic performance due to differences in lesion types, device models, examiner expertise, and patient demographic. Conclusion: Autofluorescence visualisation devices offer modest diagnostic value and should be considered as adjuncts, not replacements to conventional oral examinations and histopathological evaluation.