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Artificial intelligence in fracture detection with different image modalities and data types: A systematic review and meta-analysis

Jongyun Jung, Jingyuan Dai, Bo-Wen Liu, Qing Wu

PLOS Digital Health, 2024

20 participants · 74 citations

Abstract

Artificial Intelligence (AI), encompassing Machine Learning and Deep Learning, has increasingly been applied to fracture detection using diverse imaging modalities and data types. This systematic review and meta-analysis aimed to assess the efficacy of AI in detecting fractures through various imaging modalities and data types (image, tabular, or both) and to synthesize the existing evidence related to AI-based fracture detection. Peer-reviewed studies developing and validating AI for fracture detection were identified through searches in multiple electronic databases without time limitations. A hierarchical meta-analysis model was used to calculate pooled sensitivity and specificity. A diagnostic accuracy quality assessment was performed to evaluate bias and applicability. Of the 66 eligible studies, 54 identified fractures using imaging-related data, nine using tabular data, and three using both. Vertebral fractures were the most common outcome (n = 20), followed by hip fractures (n = 18). Hip fractures exhibited the highest pooled sensitivity (92%; 95% CI: 87–96, p< 0.01) and specificity (90%; 95% CI: 85–93, p< 0.01). Pooled sensitivity and specificity using image data (92%; 95% CI: 90–94, p< 0.01; and 91%; 95% CI: 88–93, p < 0.01) were higher than those using tabular data (81%; 95% CI: 77–85, p< 0.01; and 83%; 95% CI: 76–88, p < 0.01), respectively. Radiographs demonstrated the highest pooled sensitivity (94%; 95% CI: 90–96, p < 0.01) and specificity (92%; 95% CI: 89–94,…

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Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 20 participants or records.

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