{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:51:06Z","timestamp":1780919466190,"version":"3.54.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,10]],"date-time":"2025-08-10T00:00:00Z","timestamp":1754784000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,8,10]],"date-time":"2025-08-10T00:00:00Z","timestamp":1754784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100022963","name":"Key Research and Development Program of Zhejiang Province","doi-asserted-by":"publisher","award":["2025C02100"],"award-info":[{"award-number":["2025C02100"]}],"id":[{"id":"10.13039\/100022963","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Stable Support Project of Shenzhen","award":["20231122145548001"],"award-info":[{"award-number":["20231122145548001"]}]},{"name":"Natural Science Foundation of shenzhen Municipality","award":["JCYJ20220531091407016"],"award-info":[{"award-number":["JCYJ20220531091407016"]}]},{"name":"Futian Healthcare Research Project","award":["FTWS069, FTWS055"],"award-info":[{"award-number":["FTWS069, FTWS055"]}]},{"name":"Seed Fund for PI Research","award":["2402101364"],"award-info":[{"award-number":["2402101364"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"DOI":"10.1038\/s41746-025-01885-8","type":"journal-article","created":{"date-parts":[[2025,8,10]],"date-time":"2025-08-10T18:01:33Z","timestamp":1754848893000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Next-generation AI framework for comprehensive oral leukoplakia evaluation and management"],"prefix":"10.1038","volume":"8","author":[{"given":"JingWen","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YaFang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MengJing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Adeoye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane JingYa","family":"Pu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MiMi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ChuanXia","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LiJie","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colman","family":"McGrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LiWu","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,10]]},"reference":[{"key":"1885_CR1","unstructured":"Organization, W. H. Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030 (World Health Organization, 2022)."},{"key":"1885_CR2","unstructured":"Races, A. & Males, M. SEER cancer statistics review 1975-2017 (National Cancer Institute, Bethesda, MD, USA, 2020)."},{"key":"1885_CR3","doi-asserted-by":"publisher","first-page":"e2","DOI":"10.1016\/j.jcpo.2013.04.002","volume":"1","author":"P Ford","year":"2013","unstructured":"Ford, P. & Farah, C. Early detection and diagnosis of oral cancer: strategies for improvement. J. Cancer Policy 1, e2\u2013e7 (2013).","journal-title":"J. Cancer Policy"},{"key":"1885_CR4","first-page":"i","volume":"6","author":"K Awan","year":"2014","unstructured":"Awan, K. Oral cancer: early detection is crucial. J. Int. Oral Health 6, i\u2013ii (2014).","journal-title":"J. Int. Oral Health"},{"key":"1885_CR5","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1002\/hed.26006","volume":"42","author":"O Iocca","year":"2020","unstructured":"Iocca, O. et al. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck 42, 539\u2013555 (2020).","journal-title":"Head Neck"},{"key":"1885_CR6","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.1111\/odi.13704","volume":"27","author":"S Warnakulasuriya","year":"2021","unstructured":"Warnakulasuriya, S. et al. Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 27, 1862\u20131880 (2021).","journal-title":"Oral Dis."},{"key":"1885_CR7","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1111\/j.1600-0714.2007.00582.x","volume":"36","author":"S Warnakulasuriya","year":"2007","unstructured":"Warnakulasuriya, S., Johnson, N. W. & van der Waal, I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J. Oral Pathol. Med. 36, 575\u2013580 (2007).","journal-title":"J. Oral Pathol. Med."},{"key":"1885_CR8","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1111\/odi.13810","volume":"27","author":"JM Aguirre-Urizar","year":"2021","unstructured":"Aguirre-Urizar, J. M., Lafuente-Ibanez de Mendoza, I. & Warnakulasuriya, S. Malignant transformation of oral leukoplakia: Systematic review and meta-analysis of the last 5 years. Oral Dis. 27, 1881\u20131895 (2021).","journal-title":"Oral Dis."},{"key":"1885_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.105014","volume":"110","author":"I Evren","year":"2020","unstructured":"Evren, I. et al. Annual malignant transformation rate of oral leukoplakia remains consistent: a long-term follow-up study. Oral Oncol. 110, 105014 (2020).","journal-title":"Oral Oncol."},{"key":"1885_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.104550","volume":"102","author":"S Warnakulasuriya","year":"2020","unstructured":"Warnakulasuriya, S. Oral potentially malignant disorders: a comprehensive review on clinical aspects and management. Oral Oncol. 102, 104550 (2020).","journal-title":"Oral Oncol."},{"key":"1885_CR11","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/j.oraloncology.2012.04.002","volume":"48","author":"MW Ho","year":"2012","unstructured":"Ho, M. W. et al. The clinical determinants of malignant transformation in oral epithelial dysplasia. Oral Oncol. 48, 969\u2013976 (2012).","journal-title":"Oral Oncol."},{"key":"1885_CR12","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1111\/odi.15140","volume":"31","author":"LA Pimenta-Barros","year":"2025","unstructured":"Pimenta-Barros, L. A., Ramos-Garcia, P., Gonzalez-Moles, M. A., Aguirre-Urizar, J. M. & Warnakulasuriya, S. Malignant transformation of oral leukoplakia: systematic review and comprehensive meta-analysis. Oral Dis. 31, 69\u201380 (2025).","journal-title":"Oral Dis."},{"key":"1885_CR13","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1111\/odi.13993","volume":"27","author":"E Odell","year":"2021","unstructured":"Odell, E., Kujan, O., Warnakulasuriya, S. & Sloan, P. Oral epithelial dysplasia: recognition, grading and clinical significance. Oral Dis. 27, 1947\u20131976 (2021).","journal-title":"Oral Dis."},{"key":"1885_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjon.2022.100133","volume":"9","author":"S Hegde","year":"2022","unstructured":"Hegde, S., Ajila, V., Zhu, W. & Zeng, C. Artificial intelligence in early diagnosis and prevention of oral cancer. Asia Pac. J. Oncol. Nurs. 9, 100133 (2022).","journal-title":"Asia Pac. J. Oncol. Nurs."},{"key":"1885_CR15","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1038\/nature14539","volume":"521","author":"Y LeCun","year":"2015","unstructured":"LeCun, Y., Bengio, Y. & Hinton, G. Deep learning. Nature 521, 436\u2013444 (2015).","journal-title":"Nature"},{"key":"1885_CR16","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1038\/s41591-018-0316-z","volume":"25","author":"A Esteva","year":"2019","unstructured":"Esteva, A. et al. A guide to deep learning in healthcare. Nat. Med. 25, 24\u201329 (2019).","journal-title":"Nat. Med."},{"key":"1885_CR17","doi-asserted-by":"publisher","first-page":"5034","DOI":"10.1097\/JS9.0000000000001469","volume":"110","author":"J Li","year":"2024","unstructured":"Li, J. et al. Diagnostic accuracy of artificial intelligence assisted clinical imaging in the detection of oral potentially malignant disorders and oral cancer: a systematic review and meta-analysis. Int. J. Surg. 110, 5034\u20135046 (2024).","journal-title":"Int. J. Surg."},{"key":"1885_CR18","doi-asserted-by":"publisher","first-page":"adk6139","DOI":"10.1126\/science.adk6139","volume":"381","author":"EJ Topol","year":"2023","unstructured":"Topol, E. J. As artificial intelligence goes multimodal, medical applications multiply. Science 381, adk6139 (2023).","journal-title":"Science"},{"key":"1885_CR19","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.1177\/00220345241272048","volume":"103","author":"J Adeoye","year":"2024","unstructured":"Adeoye, J. et al. A deep learning system to predict epithelial dysplasia in oral leukoplakia. J. Dent Res. 103, 1218\u20131226 (2024).","journal-title":"J. Dent Res."},{"key":"1885_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-024-04191-z","volume":"24","author":"J Peng","year":"2024","unstructured":"Peng, J. et al. Oral epithelial dysplasia detection and grading in oral leukoplakia using deep learning. BMC Oral Health 24, 434 (2024).","journal-title":"BMC Oral Health"},{"key":"1885_CR21","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/jop.12983","volume":"49","author":"X Wang","year":"2020","unstructured":"Wang, X. et al. A personalized computational model predicts cancer risk level of oral potentially malignant disorders and its web application for promotion of non-invasive screening. J. Oral Pathol. Med. 49, 417\u2013426 (2020).","journal-title":"J. Oral Pathol. Med."},{"key":"1885_CR22","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1093\/jnci\/djz238","volume":"112","author":"AK Chaturvedi","year":"2020","unstructured":"Chaturvedi, A. K. et al. Oral leukoplakia and risk of progression to oral cancer: a population-based cohort study. J. Natl Cancer Inst. 112, 1047\u20131054 (2020).","journal-title":"J. Natl Cancer Inst."},{"key":"1885_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104557","volume":"154","author":"J Adeoye","year":"2021","unstructured":"Adeoye, J., Tan, J. Y., Choi, S. W. & Thomson, P. Prediction models applying machine learning to oral cavity cancer outcomes: a systematic review. Int. J. Med. Inform. 154, 104557 (2021).","journal-title":"Int. J. Med. Inform."},{"key":"1885_CR24","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s12105-024-01643-4","volume":"18","author":"SA Alajaji","year":"2024","unstructured":"Alajaji, S. A., Khoury, Z. H., Jessri, M., Sciubba, J. J. & Sultan, A. S. An update on the use of artificial intelligence in digital pathology for oral epithelial dysplasia research. Head Neck Pathol. 18, 38 (2024).","journal-title":"Head Neck Pathol."},{"key":"1885_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2022.105967","volume":"132","author":"A Ferrer-Sanchez","year":"2022","unstructured":"Ferrer-Sanchez, A., Bagan, J., Vila-Frances, J., Magdalena-Benedito, R. & Bagan-Debon, L. Prediction of the risk of cancer and the grade of dysplasia in leukoplakia lesions using deep learning. Oral Oncol. 132, 105967 (2022).","journal-title":"Oral Oncol."},{"key":"1885_CR26","doi-asserted-by":"publisher","first-page":"46057","DOI":"10.18632\/oncotarget.17550","volume":"8","author":"Y Liu","year":"2017","unstructured":"Liu, Y. et al. Quantitative prediction of oral cancer risk in patients with oral leukoplakia. Oncotarget 8, 46057\u201346064 (2017).","journal-title":"Oncotarget"},{"key":"1885_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2024.105421","volume":"186","author":"S Uppal","year":"2024","unstructured":"Uppal, S., Kumar Shrivastava, P., Khan, A., Sharma, A. & Kumar Shrivastav, A. Machine learning methods in predicting the risk of malignant transformation of oral potentially malignant disorders: a systematic review. Int. J. Med. Inform. 186, 105421 (2024).","journal-title":"Int. J. Med. Inform."},{"key":"1885_CR28","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1177\/10668969211070171","volume":"30","author":"ZH Khoury","year":"2022","unstructured":"Khoury, Z. H., Sultan, M. & Sultan, A. S. Oral epithelial dysplasia grading systems: a systematic review & meta-analysis. Int. J. Surg. Pathol. 30, 499\u2013511 (2022).","journal-title":"Int. J. Surg. Pathol."},{"key":"1885_CR29","doi-asserted-by":"publisher","unstructured":"Ellonen, R. et al. Binary- and three-tiered oral epithelial dysplasia grading system and malignant transformation. Oral Dis. https:\/\/doi.org\/10.1111\/odi.15334 (2025).","DOI":"10.1111\/odi.15334"},{"key":"1885_CR30","unstructured":"Tomasev, N. et al. Pushing the limits of self-supervised resnets: can we outperform supervised learning without labels on imagenet? arXiv preprint arXiv:2201.05119 (2022)."},{"key":"1885_CR31","unstructured":"Barnes, L. Pathology and Genetics of Head and Neck Tumours Vol. 9 (IARC, 2005)."},{"key":"1885_CR32","unstructured":"El-Naggar, A. K., Chan, J. K., Rubin Grandis, J. & Slootweg, P. J. WHO Classification of Head and Neck Tumours (WHO, 2017)."},{"key":"1885_CR33","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1002\/path.1285","volume":"199","author":"MP Tabor","year":"2003","unstructured":"Tabor, M. P. et al. Comparative molecular and histological grading of epithelial dysplasia of the oral cavity and the oropharynx. J. Pathol. 199, 354\u2013360 (2003).","journal-title":"J. Pathol."},{"key":"1885_CR34","unstructured":"Nagpal, C., Potosnak, W. & Dubrawski, A. Auton-survival: an open-source package for regression, counterfactual estimation, evaluation and phenotyping with censored time-to-event data. In Proc. Machine Learning for Healthcare Conference, 585\u2212608 (2022)."},{"key":"1885_CR35","doi-asserted-by":"crossref","unstructured":"Kendall, A., Gal, Y., Cipolla, R. Multi-task learning using uncertainty to weigh losses for scene geometry and semantics. In Proc. IEEE conference on computer vision andpattern recognition, 7482\u22127491 (2018).","DOI":"10.1109\/CVPR.2018.00781"},{"key":"1885_CR36","unstructured":"Liebel, L. & K\u00f6rner, M. Auxiliary tasks in multi-task learning. arXiv preprint arXiv:1805.06334 (2018)."},{"key":"1885_CR37","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1214\/15-EJS1035","volume":"9","author":"E LeDell","year":"2015","unstructured":"LeDell, E., Petersen, M. & van der Laan, M. Computationally efficient confidence intervals for cross-validated area under the ROC curve estimates. Electron. J. Stat. 9, 1583\u20131607 (2015).","journal-title":"Electron. J. Stat."},{"key":"1885_CR38","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1007\/s10994-018-5714-4","volume":"107","author":"I Tsamardinos","year":"2018","unstructured":"Tsamardinos, I., Greasidou, E. & Borboudakis, G. Bootstrapping the out-of-sample predictions for efficient and accurate cross-validation. Mach. Learn. 107, 1895\u20131922 (2018).","journal-title":"Mach. Learn."},{"key":"1885_CR39","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1136\/bmj.328.7447.1073","volume":"328","author":"JM Bland","year":"2004","unstructured":"Bland, J. M. & Altman, D. G. The logrank test. BMJ 328, 1073 (2004).","journal-title":"BMJ"}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01885-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01885-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01885-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T16:02:36Z","timestamp":1757347356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01885-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,10]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1885"],"URL":"https:\/\/doi.org\/10.1038\/s41746-025-01885-8","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,10]]},"assertion":[{"value":"19 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"513"}}