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

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.