PICUP - Point-of-Care Fracture Prediction

人口老龄化及其对准确医疗诊断的需求是世界范围内一个重大且不断升级的卫生负担。特别值得关注的是骨质疏松症（OP）等骨骼疾病，因为这导致非常高的医疗负担，特别是在老年人中。在英国，每月有超过1000人死于与OP相关的髋部骨折，NHS每年与OP髋部骨折相关的费用为20亿英镑。这一建议涉及开发一种新的临床仪器来预测个体的骨质疏松性骨折，从而提高生活质量并减轻这种健康负担。该提案首次将两种最近开发的技术结合在一种新的即时护理临床仪器中。这项建议是根据最近完成的EPSRC研究项目“即时护理高精度骨折风险预测”（EP/K020196/1）发展而来的。这迈出了为裂缝预测新方法提供基础科学和工程原理证明的第一步。其前提是骨是一种复杂的工程材料，其成分对其性能至关重要，即骨质疏松导致的断裂强度降低与结构、质量和材料化学的变化有关。这项工作还试图为一种新的测量技术（焦点构造技术，FCT）提供原理证明，该技术可以根据x射线散射得出关键的化学特征。该研究取得了巨大的成功，发现了一组新的对骨质疏松症敏感的生物标志物，并且证明了新的数据采集方法可以在所需的精度范围内提供量化参数。在过去的18个月里，其他较小的（短期）开发研究补助金（IAA）也使我们能够探索替代几何形状的选择，并在测量空间内使用其他光学元件。此外，目前的联合STFC研究计划（ST/N006526/1）正在探索将我们的FCT方法与一种新型像素化检测器Hexitec结合使用，尽管是在不同的应用领域。在这个阶段，技术风险仍然很高，对这类研究的需求是切实的，潜在的社会和经济效益非常大。

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.