Dalal, G, Bromiley, PA, Kariki, EP, Luetchens, S, Cootes, TF and Payne, K (2022) Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study. Aging Clinical and Experimental Research, 34 (8). 1909 - 1918.

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Abstract

Background There is an emerging interest in using automated approaches to enable the incidental identifcation of vertebral
fragility fractures (VFFs) on existing medical images visualising the spine.
Aim To quantify values, and the degree of uncertainty associated with them, for the incidental identifcation of VFFs from
computed tomography (CT) scans in current practice.
Methods An expert elicitation exercise was conducted to generate point estimates and measures of uncertainty for four values
representing the probability of: VFF being correctly reported by the radiologist; the absence of VFF being correctly assessed
by the radiologist; being referred for management when a VFF is identifed; having a dual-energy X-ray absorptiometry
(DXA) scan after general practitioner (GP) referral. Data from a sample of seven experts in the diagnosis and management
of people with VFFs were pooled using mathematical aggregation.
Results The estimated mean values for each probability parameter were: VFF being correctly reported by the radiolo�gist=0.25 (standard deviation (SD): 0.21); absence of VFF being correctly assessed by the radiologist=0.89 (0.10); being
referred for management when a VFF is identifed by the radiologist=0.15 (0.12); having a DXA scan after GP referral=0.66
(0.28).
Discussion These estimates could be used to facilitate the subsequent early economic evaluation of potential new approaches
to improve the health outcomes of people with VFFs.
Conclusion In the absence of epidemiological studies, this study produced point estimates and measures of uncertainty for
key parameters needed to describe current pathways for the incidental diagnosis of VFFs

Item Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
Uncontrolled Keywords: Incidental identifcation; Expert elicitation; Vertebral fragility fractures; Osteoporosis; Artifcial intelligence; Diagnosis; Prevention; CT; Radiological
Subjects: Q Science > Q Science (General) > Q335 Artificial Intelligence
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
R Medicine > RM Therapeutics. Pharmacology > Physical medicine. Physical therapy. Including massage, exercise, occupational therapy, hydrotherapy, phototherapy, radiotherapy, thermotherapy, electrotherapy
Divisions: Faculty of Medicine and Health Sciences > School of Allied Health Professions
Depositing User: Symplectic
Date Deposited: 26 Apr 2023 15:15
Last Modified: 26 Apr 2023 15:15
URI: https://eprints.keele.ac.uk/id/eprint/12265

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