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| Claim to evaluate | What the meta-analysis reports | Key reasons to be skeptical | Confidence (from reported evidence quality) |
|---|---|---|---|
| βAll modalities distinguish psychosis vs controls with moderate accuracy.β | Pooled internal sensitivity/specificity for T1 (~0.73/0.77), DTI (~0.71/0.73), rs-FC (~0.76/0.81), multimodal (~0.81/0.79). | High heterogeneity (I2 ~91.8%); ML performance in internal validation is vulnerable to overfitting/data leakage (common failure mode in ML-neuroimaging literature, especially with design/reporting variation). | Moderate (pooled signals exist, but dispersion/bias are large). |
| βrs-FC has a slight advantage; multimodal adds limited benefit.β | rs-FC internal ~0.76/0.81; multimodal internal ~0.81/0.79. External results: rs-FC often competitive vs T1 in the pooled extract. | Multimodal benefit can be diluted by inconsistent fusion strategies, different preprocessing choices, and variable modality inclusion across studies; pooled multimodal vs unimodal comparisons are sensitive to which study configurations dominate. | Moderate-to-weak (directional tendency, but heterogeneity + bias limit effect-size certainty). |
| βExternal validation confirms generality.β | External pooled metrics are lower than internal; external specificity/sensitivity provided for T1 and rs-FC in the extract. | External validation coverage may be incomplete across modalities; pooled external metrics are still vulnerable to dataset overlap, protocol differences, and limited βindependentβ diversity in scanners/demographics. | Weak-to-moderate (generalization appears worse, and uncertainty remains high). |
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