Clinical Validation of OsteoSight - AI technology for incidental detection of osteoporosis

在英国，每年有超过50万人因骨质疏松症而接受脆性骨折的医院治疗，花费NHS超过40亿英镑。费用远远超出了直接的医疗护理。髋部骨折后，40%的患者不能独立行走，10- 20%的患者需要永久的住院护理。如果早期诊断，骨质疏松症可以通过改变生活方式和/或药物治疗得到有效的管理，并降低骨折风险。尽管如此，**75%的骨质疏松症患者仍未得到诊断 ** 和治疗。诊断依赖于全科医生识别有风险的患者，并将他们转介到一个特定的扫描，测量骨矿物质密度（BMD），称为DEXA扫描。然而，由于几乎没有症状或体征，以及全科医生面临前所未有的时间限制，由于劳动力的压力，传统的骨质疏松症筛查是行不通的。Naive Technologies开发了OsteoSight，一种图像分析工具，利用每年拍摄的数千张X光片中包含的隐藏信息，用于许多与骨密度无关的原因。OsteoSight自动分析髋关节和骨盆X射线，以产生骨矿物质密度（BMD）的估计值，然后可以用来提醒患者的GP，患者有骨质疏松症的风险。在开发过程中，OsteoSight的结果显示与DEXA测量的历史数据BMD密切相关。该项目将评估OsteoSight在其预期临床环境-门诊成像中对新数据的表现。作为皇家国家骨科医院研究的一部分，50岁以上接受髋关节或骨盆X光检查的门诊患者将被邀请通过OsteoSight评估他们的骨骼健康X光片，然后进行DEXA。他们将被要求填写一份调查问卷，重点是他们对骨骼健康和骨质疏松症风险因素的理解。然后将OsteoSight的结果与DEXA进行比较，以了解OsteoSight的性能如何，以及它是否受到年龄，种族和临床因素（如吸烟）的影响。为了在NHS中产生最大影响，OsteoSight需要无缝操作，捕获正确的患者并将结果发送到他们需要的地方，而不会造成额外的劳动力压力。作为该项目的一部分，将建立一个病人发现平台，以满足这些要求，以及在NHS部署所需的要求。该项目有可能改变成千上万的病人的生活-通过减少A&E出勤率和紧急程序，病床和手术室可以释放，以减少等待名单。

Every year in the UK, over 500,000 people receive hospital treatment for fragility fractures as a result of osteoporosis, costing the NHS over £4bn. The cost extends well beyond immediate medical care. After a hip fracture, 40% of patients cannot walk independently and 10--20% need permanent residential care.If diagnosed early, osteoporosis can be effectively managed, and fracture risk reduced, by lifestyle changes and/or medication. Despite this, **75% of individuals with osteoporosis remain undiagnosed** and untreated. Diagnosis relies on GPs identifying at-risk patients and referring them for a specific scan that measures bone mineral density (BMD), called a DEXA scan. However, with few signs or symptoms, and GPs facing unprecedented time-constraints due to workforce pressures, traditional osteoporosis screening is not working.Naitive Technologies have developed OsteoSight, an image analysis tool that leverages the hidden information contained in the thousands of x-rays that are taken every year, for lots of _reasons unrelated to bone density_. OsteoSight automatically analyses hip and pelvic x-rays to produce an estimate of bone mineral density (BMD), which can then be used to alert the patient's GP that the patient is at-risk for osteoporosis. In development OsteoSight results were shown to closely correlate with BMD, as measured by DEXA, on historic data.This project will assess how well OsteoSight performs on new data in its intended clinical setting -- outpatient imaging. As part of a study with the Royal National Orthopaedic Hospital, outpatients over 50 years undergoing hip or pelvis x-rays will be invited to have their x-rays assessed for bone health by OsteoSight, and then DEXA. They will be asked to fill in a questionnaire focused on their understanding of bone health and the risk factors for osteoporosis. The results of OsteoSight will then be compared with DEXA to see how well OsteoSight performs, and if it is affected by age, ethnicity and clinical factors such as smoking.For greatest impact in the NHS, OsteoSight will need to operate seamlessly, capturing the right patients and sending results to where they need to go, without causing additional workforce pressures. As part of this project, a patient discovery platform will be built to meet these requirements, as well as those needed for deployment in the NHS.This project has the potential to change the lives of thousands of patients -- by reducing A&E attendances & emergency procedures, beds and operating theatres can be freed to reduce waiting lists.