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

在英国，每年有超过50万人因骨质疏松导致的脆性骨折而接受医院治疗，NHS花费超过40亿英镑。其成本远远超出了即时医疗护理。髋部骨折后，40%的患者不能独立行走，10- 20%需要永久性住院护理。如果早期诊断出骨质疏松症，可以通过改变生活方式和/或药物治疗有效地控制和降低骨折风险。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，并将他们转介进行特定的扫描，测量骨密度（BMD），称为DEXA扫描。然而，由于几乎没有迹象或症状，由于劳动力压力，全科医生面临前所未有的时间限制，传统的骨质疏松症筛查不起作用。native Technologies开发了OsteoSight，这是一种图像分析工具，可以利用每年拍摄的数千张x射线中包含的隐藏信息，这些x射线的原因与骨密度无关。OsteoSight自动分析髋关节和骨盆x光片，以产生骨矿物质密度（BMD）的估计，然后可以用来提醒病人的全科医生，病人有患骨质疏松症的风险。在发展过程中，骨质疏松结果显示与骨密度密切相关，骨密度由DEXA测量，在历史数据上。该项目将评估OsteoSight在其预期的临床环境（门诊成像）中对新数据的表现。作为与英国皇家国立骨科医院（Royal National Orthopaedic Hospital）合作的一项研究的一部分，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由OsteoSight和DEXA对他们的x光片进行骨骼健康评估。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了解。然后将OsteoSight的结果与DEXA进行比较，看看OsteoSight的效果如何，以及它是否受到年龄、种族和吸烟等临床因素的影响。为了对NHS产生最大的影响，OsteoSight将需要无缝运行，捕获合适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，将建立一个患者发现平台来满足这些要求，以及在NHS中部署所需的要求。这个项目有可能改变成千上万病人的生活——通过减少急诊室的就诊率和急诊程序，可以腾出床位和手术室，减少等候名单。

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.