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Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study

BACKGROUND: There is an emerging interest in using automated approaches to enable the incidental identification 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 id...

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Autores principales: Dalal, Garima, Bromiley, Paul A., Kariki, Eleni P., Luetchens, Shawn, Cootes, Timothy F., Payne, Katherine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283144/
https://www.ncbi.nlm.nih.gov/pubmed/35435584
http://dx.doi.org/10.1007/s40520-022-02124-w
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author Dalal, Garima
Bromiley, Paul A.
Kariki, Eleni P.
Luetchens, Shawn
Cootes, Timothy F.
Payne, Katherine
author_facet Dalal, Garima
Bromiley, Paul A.
Kariki, Eleni P.
Luetchens, Shawn
Cootes, Timothy F.
Payne, Katherine
author_sort Dalal, Garima
collection PubMed
description BACKGROUND: There is an emerging interest in using automated approaches to enable the incidental identification 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 identification 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 identified; 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 radiologist = 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 identified 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-022-02124-w.
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spelling pubmed-92831442022-07-16 Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study Dalal, Garima Bromiley, Paul A. Kariki, Eleni P. Luetchens, Shawn Cootes, Timothy F. Payne, Katherine Aging Clin Exp Res Original Article BACKGROUND: There is an emerging interest in using automated approaches to enable the incidental identification 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 identification 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 identified; 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 radiologist = 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 identified 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-022-02124-w. Springer International Publishing 2022-04-18 2022 /pmc/articles/PMC9283144/ /pubmed/35435584 http://dx.doi.org/10.1007/s40520-022-02124-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Dalal, Garima
Bromiley, Paul A.
Kariki, Eleni P.
Luetchens, Shawn
Cootes, Timothy F.
Payne, Katherine
Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study
title Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study
title_full Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study
title_fullStr Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study
title_full_unstemmed Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study
title_short Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study
title_sort understanding current uk practice for the incidental identification of vertebral fragility fractures from ct scans: an expert elicitation study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283144/
https://www.ncbi.nlm.nih.gov/pubmed/35435584
http://dx.doi.org/10.1007/s40520-022-02124-w
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