Diagnostic efficacy of VELscope in oral potentially malignant disorders: a systematic review and meta-analysis

Purpose This study aimed to evaluate the diagnostic efficacy of VELscope in detecting oral potentially malignant disorders (OPMD). Methods A systematic search was conducted across six English databases and two Chinese databases: Embase, Web of Science, PubMed, Scopus, Dentistry & Oral Sciences Source (EBSCO), CINAHL (EBSCO), China National Knowledge Infrastructure (CNKI), and Chinese biomedical literature service system (SinoMed). Prospective and cross-sectional studies using VELscope to diagnose OPMD were included. Study quality was assessed using QUADAS-2. The meta-analysis evaluated VELscope's sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the summary receiver operating characteristic (SROC) curve. Heterogeneity was assessed via Deeks’ funnel plot asymmetry test, bivariate boxplot, and meta-regression analysis to identify sources of variation. Results A total of 2054 studies were retrieved, of which 24 were included in the meta-analysis. The sensitivity of VELscope was 84% (95% CI, 0.78–0.89; I 2 = 78.0%), specificity was 45% (95% CI, 0.33–0.59; I 2 = 93.8%), and the positive likelihood ratio was 1.55 (95% CI, 1.22–1.96; I 2 = 86.9%). The area under the SROC curve was 0.78 (95% CI, 0.74–0.81). Subgroup analysis indicated that SCIE indexing, comparative study design, and high risk of bias influenced the sensitivity of VELscope. Conclusion The VELscope demonstrates high sensitivity but limited specificity in diagnosing OPMD. Although it is unreasonable to rely solely on VELscope for a definitive diagnosis, it can provide valuable adjunctive support for detecting OPMD in settings such as large-scale screenings, community oral examinations, and resource-limited environments. Systematic Review Registration PROSPERO (CRD42025364593).