Artificial intelligence in Prechtl’s General Movements Assessment: A systematic review and meta-analysis

Objective To evaluate AI-assisted GMA performance for (i) prediction of later cerebral palsy (CP) diagnosis and (ii) classification of expert-rated GMA labels, and to assess heterogeneity and risk of bias. Methods A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. A total of 105 studies were included in qualitative synthesis, of which 28 were eligible for quantitative synthesis. Random-effects meta-analysis of proportions with logit transformation was used to estimate pooled diagnostic accuracy. Results Of 105 eligible studies in qualitative synthesis, 28 were included in quantitative synthesis (17 CP diagnosis outcomes; 11 expert GMA label outcomes). For CP diagnosis outcomes, the pooled diagnostic accuracy was 0.884 (95% CI: 0.838–0.918). For expert-rated GMA label outcomes, the pooled classification accuracy was 0.848 (95% CI: 0.761–0.908). Heterogeneity was substantial across analyses. Interpretation AI-assisted GMA shows high pooled performance for both CP diagnosis prediction and expert-label classification; however, certainty remains very low due to heterogeneity and risk of bias. No single GM developmental phase, or sensor modality, demonstrated clear superiority, underscoring the importance of standardized protocols, high-quality datasets, and transparent validation. These findings support the clinical potential of AI-enabled GMA as an objective and scalable screening tool, particularly in settings with limited access to specialized expertise.