From surveillance to intelligence: a scoping review of machine learning for antimicrobial resistance surveillance intelligence across One Health
Abstract
Background: Antimicrobial resistance (AMR) is a leading global health threat requiring coordinated surveillance across human, animal, environmental, and genomic systems. Machine learning is increasingly applied to AMR data, yet its contribution to actionable surveillance intelligence, rather than prediction alone, remains poorly defined.
Objective: To map how machine-learning approaches generate AMR surveillance intelligence, to characterise their validation and implementation maturity, and to propose a framework distinguishing technical prediction from actionable surveillance intelligence.
Methods: We conducted a scoping review following JBI methodology and PRISMA-ScR reporting. PubMed/MEDLINE, Scopus, and Web of Science were searched from January 2015 to May 2026 for studies applying machine learning or related methods to AMR surveillance intelligence. Two reviewers independently screened and charted records. Of 1,985 records, 66 met eligibility and formed the working evidence base; 41 studies (40 core empirical and one supporting preprint) were appraised against TRIPOD+AI- and PROBAST-aligned reporting, validation, and implementation-readiness domains.
Results: Machine learning was applied across five clusters: clinical and electronic-health-record risk prediction and decision support; genomic and whole-genome-sequencing prediction; MALDI-TOF-based rapid resistance prediction; wastewater and metagenomic surveillance; and environmental, animal, food-chain, and One Health…
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Evidence Hub reads this as a systematic review, done in computer models (in silico), not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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