Meta-analysis finds machine learning models predict depression in diabetes with AUC 0.822

BackgroundCurrently, numerous studies have employed machine learning (ML) methods to develop predictive models for depression risk in patients with diabetes mellitus (DM); however, the findings remain inconsistent. Therefore, this study aims to clarify the current state of research and emerging trends in this field by systematically evaluating the performance, strengths, and limitations of existing prediction models.ObjectiveThis systematic review evaluates the performance and clinical applicability of ML-based depression risk prediction models for patients with DM, providing reliable evidence to assist healthcare professionals in selecting and optimizing more appropriate prediction models.MethodsWe conducted a systematic search of clinical studies employing ML approaches to predict depression risk in patients with DM across the PubMed, Embase, Cochrane Library, and Web of Science databases, from their inception to January 2026. The primary performance metric for the models was the area under the receiver operating characteristic curve (AUC) along with its 95% confidence interval (95% CI). Two independent researchers screened the literature, extracted data, and used PROBAST-AI to assess the risk of bias and clinical applicability of the included studies. Pooled AUC was estimated using the Der Simonian and Laird random-effects model.ResultsA total of 14 studies comprising 64 distinct ML models were included. All included studies were assessed as high risk of bias and high clinical applicability. A pooled analysis of the best-performing ML prediction models reported in each study showed a pooled AUC of 0.822 (95% CI, 0.789-0.858), indicating relatively good overall predictive performance. However, there was substantial heterogeneity among the studies (I² = 97.4%; P