PICUP - Point-of-Care Fracture Prediction

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A significant and escalating worldwide health burden is the ageing population and its demand for accurate medical diagnostics. Of particular concern are osteo diseases such as osteoporosis (OP) as this results in a very high healthcare burden, particularly in elderly populations. More than 1000 people die every month in the UK from OP related hip fractures and the NHS costs associated with OP hip fracture are >£2.0b per annum.This proposal concerns the development of a new clinical instrument to predict osteoporotic fractures within an individual and thus improve quality of life and reduce this health burden. The proposal, for the first time, will combine two recently developed technologies within a new, point-of-care clinical instrument. This proposal has been developed from a recently completed EPSRC research programme, "Point-of-Care High Accuracy Fracture Risk Prediction" (EP/K020196/1). This took the first research steps towards providing the underpinning science and engineering proof of principle for a new approach to fracture prediction. It was premised upon the thesis that bone is a complex engineering material where composition is critical to performance, i.e. osteoporotic compromise of fracture strength is related to changes in architecture, mass and material chemistry. The work also attempted to secure proof of principle for a new measurement technique (focal construct technology, FCT) that could derive critical chemistry features based upon X-ray scattering. The research was a great success in that a new set of biomarkers, sensitive to osteoporosis, was discovered, and the novel data acquisition approach was demonstrated to provide the quantified parameters within the required precision. Other, smaller (short term) development research grants (IAA) awarded within the previous 18 months have also enabled us to explore options for alternative geometries and the use of other optical elements within the measurement space. Further, a current, joint STFC research programme (ST/N006526/1) is exploring the combined use of our FCT approach with a novel pixelated detector, Hexitec, albeit within a different application sector. At this stage, the technological risks remain high, the demand for such research is tangible, and the potential societal and financial benefits are very large.