The potential role for artificial intelligence in fracture risk prediction.

Journal: The lancet. Diabetes & endocrinology
Published Date:

Abstract

Osteoporotic fractures are a major health challenge in older adults. Despite the availability of safe and effective therapies for osteoporosis, these therapies are underused in individuals at high risk for fracture, calling for better case-finding and fracture risk assessment strategies. Artificial intelligence (AI) and machine learning (ML) hold promise for enhancing identification of individuals at high risk for fracture by distilling useful features from high-dimensional data derived from medical records, imaging, and wearable devices. AI-ML could enable automated opportunistic screening for vertebral fractures and osteoporosis, home-based monitoring and intervention targeting lifestyle factors, and integration of multimodal features to leverage fracture prediction, ultimately aiding improved fracture risk assessment and individualised treatment. Optimism must be balanced with consideration for the explainability of AI-ML models, biases (including information inequity in numerically under-represented populations), model limitations, and net clinical benefit and workload impact. Clinical integration of AI-ML algorithms has the potential to transform osteoporosis management, offering a more personalised approach to reduce the burden of osteoporotic fractures.

Authors

  • Namki Hong
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. nkhong84@yuhs.ac.
  • Danielle E Whittier
    McCaig Institute for Bone and Joint Health and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
  • Claus-C Glüer
    Section Biomedical Imaging, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
  • William D Leslie
    From the Department of Radiology, University of Manitoba, 820 Sherbrook St, GA216, Winnipeg, MB, Canada R3T 2N2 (S.D., C.K., D.K., M.J.J., J.M.D., W.D.L.); and St Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada (C.K., D.K.).