Background:
Fractures are a significant public health problem resulting in morbidity/mortality and socio-economic burden. EU spending on osteoporotic fractures and related inpatient hospital costs exceed €40-50 billion/annum. Osteoporotic fracture expenditure in Ireland is >€1billion/annum. Inpatient osteoporosis and fracture hospital costs exceed other NCDs (cancer/CVD). Irish public hospital bed occupancy related to adult (≥50 years) fragility fractures increased by 43% (2008-2017). >70,000 DXA (Dual-energy X-ray Absorptiometry) scans are performed in Ireland/annum. While public waiting-times for testing exceed 10 years, some referrals are un-necessary. Early osteoporotic bone fracture diagnosis helps prevent fractures and ease financial burden. DXA machines measure bone mineral density (BMD) and other biometrics. DXA secondary data could provide low-cost diagnostic-disease prediction for diabetes and cancer. Individuals with low BMD/prevalent fractures are at greater risk of cardiovascular disease (CVD), fracture and co-morbidity/mortality than non-osteoporotic patients. BMD may be a relevant surrogate factor for some COVID-19 outcomes. Artificial Intelligence (AI) applications demonstrate significant success in predicting risk, modelling disease progression and prognosis, and supporting intervention recommendations.
This project aims to develop a personalised patient-informed DXA MAP (Management Application Project) tool for the Irish population underpinned by validated diagnostic-criteria, reference standards and AI-driven fracture-risk, multi-morbidity/mortality and COVID-19 prediction algorithms. With 3 participating university hospitals (Galway, Manorhamilton and Sligo) the research question is;”How can DXA secondary-data (linked with other hospital data and underpinned by AI) contribute to more effective osteoporosis screening strategies, and create personalised patient-centred fracture, COVID-19 and multi-morbidity/mortality risk assessments?”.
Plan of investigation:
Project management(WP1)
Requirements(WP2)
Data harvesting(WP3)
Modelling(WP4)
DXA MAP tool(WP5)
Testing(WP6)
Dissemination(WP7)
Policy:
Improvements in quality service planning and provision
Contributions to effective illness-management
Development and strengthening partnerships (patients, public, researchers, data-controllers and knowledge-users)
Practice: Integration of project findings into clinical-workflow
Development of personalised patient-centred care
