Opportunistic AI screening for osteoporosis via chest X-ray is cost-effective, feasible
Using AI to opportunistically screen for osteoporosis via chest X-ray is cost-effective and feasible, according to new research published Wednesday in JACR.
Often referred to as the “silent disease,” this concern can go undiagnosed until a fracture occurs, leading to substantial healthcare costs, lower quality of life and greater risk of death. Dual-energy X-ray absorptiometry is the gold standard for identifying osteoporosis, experts note. But it comes with challenges such as technical complexity, limited accessibility, costs and the need for specialized equipment.
Researchers aimed to assess whether chest X-rays, gathered for other purposes, could boost screening in an economically feasible fashion. They found clear benefit based on their modeling study while highlighting the need for real-world investigations to further enhance the accuracy of their estimates.
“This study underscores the cost-effectiveness and public health value of opportunistic, AI-driven osteoporosis screening using existing chest radiographs, demonstrating its potential to improve early detection and address unmet diagnostic needs in osteoporosis care,” Mickael Hiligsmann, PhD, with Maastricht University in the Netherlands, and co-authors concluded.
For the study, researchers built an economic model, estimating the cost per quality-adjusted life year gained ($2,024) for screening via chest X-ray with deep learning followed by treatment. This was compared against no screening and subsequent treatment. The opportunistic screening strategy improved health outcomes, yielding more quality-adjusted life years and fewer fractures while increasing treatment costs, the authors reported. AI-enhanced analysis of existing chest X-rays improved early detection in women 50 and older. The economic model calculated a cost of $72,085 per quality-adjusted life years gained, which is below the standard U.S. threshold of $100,000 to $150,000.
“Cost-effectiveness could be optimized when screening is paired with effective follow-up, timely treatment initiation, and adherence strategies,” the authors reported.
The opportunistic screening intervention remained economically feasible, if the added cost of the AI tool did not exceed $62 per patient.
Read much more in the Journal of the American College of Radiology, including potential study limitations. Researchers also recently explored how CT-based opportunistic screening for osteoporosis could potentially save Medicare upward of $2.5 billion in another JACR study published in March.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.