PICUP - Point-of-Care Fracture Prediction

一个重大和不断升级的全球健康负担是人口老龄化及其对准确医疗诊断的需求。特别值得关注的是骨疾病，如骨质疏松症（OP），因为这会导致非常高的医疗负担，特别是在老年人群中。在英国，每个月有超过1000人死于OP相关的髋部骨折，与OP髋部骨折相关的NHS费用每年超过20亿英镑。该提案涉及开发一种新的临床工具来预测个体内的骨质疏松性骨折，从而提高生活质量并减轻健康负担。该提案首次将联合收割机两项最新开发的技术结合在一种新的即时临床仪器中。该建议是根据最近完成的EPSRC研究计划“床旁高精度骨折风险预测”（EP/K 020196/1）制定的。这迈出了第一个研究步骤，为断裂预测的新方法提供了基础科学和工程原理证明。该论文认为，骨是一种复杂的工程材料，其组成对性能至关重要，即断裂强度的生物学折衷与结构、质量和材料化学的变化有关。这项工作还试图确保一种新的测量技术（焦点结构技术，FCT）的原理证明，该技术可以根据X射线散射得出关键的化学特征。该研究取得了巨大成功，发现了一组对骨质疏松症敏感的新生物标志物，并证明了新的数据采集方法可以在所需精度内提供量化参数。在过去18个月内获得的其他较小（短期）开发研究赠款（IAA）也使我们能够探索替代几何形状的选择以及在测量空间内使用其他光学元件。此外，目前，联合STFC研究计划（ST/N 006526/1）正在探索我们的FCT方法与新型像素化探测器Hexitec的组合使用，尽管在不同的应用领域。在这一阶段，技术风险仍然很高，对这种研究的需求是有形的，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.