A comparative evaluation of concordance and speed between smartphone app-based and artificial intelligence web-based cephalometric tracing software with the manual tracing method: A cross-sectional study

Background: This study compared the accuracy and speed of cephalometric analysis using an artificial intelligence web-based method and a smartphone app-based system with manual cephalometric analysis as the reference standard. Material and Methods: In this cross-sectional study, the lateral cephalograms were analysed using four methods: manual tracing, smartphone app tracing, artificial intelligence web-based automated tracing without manual landmark identification correction and artificial intelligence web-based automated tracing with manual landmark identification correction. The principal investigator obtained linear and angular cephalometric measurements to compare the accuracies of the four methods being assessed. Additionally, the duration required for landmark identification and subsequent analysis was recorded. Results: The analyses included 40 lateral cephalograms that were selected based on the inclusion and exclusion criteria. Very good to excellent agreement was observed in the accuracies of the artificial intelligence web-based and smartphone app-based systems compared with manual tracing (interclass correlation coefficient values ranging from 0.707 to 0.9, p < 0.001). Of the artificial intelligence web-based systems, the method without correction of automated landmark detection showed less reliable measurements than the other methods. Cephalometric analysis using artificial intelligence web-based and smartphone app-based systems consumed less time than manual tracing (p < 0.001). Conclusions: Artificial intelligence web-based automated tracing with manual landmark identification correction and smartphone-based app provide results that are comparable to those from the manual tracing method. However, artificial intelligence web-based systems require improvements in terms of automated landmark identification to obtain results that are similar to those from the other methods being assessed.