Screening women for osteoporosis using AI analysis of chest X-rays acquired for other clinical indications meets U.S. thresholds for cost-effectiveness. That’s according to a new study in JACR that highlights the potential of radiography AI for opportunistic screening.
Osteoporosis screening is already performed using DEXA scanners that detect bone density loss in women.
- But DEXA scanners aren’t always available, and dedicated screening for just one condition can be expensive.
Using AI to analyze chest X-rays that women might be getting for other conditions could expand the pool of women being screened for osteoporosis without incurring significant additional costs.
- Indeed, Japanese researchers recently published a study honing in on the best techniques for AI-enhanced osteoporosis screening with radiography.
In the new study, researchers performed a modeling analysis that simulated the cost-effectiveness of an osteoporosis screening program based on AI-enhanced chest radiographs for U.S. women aged 50 and up.
- The cost analysis compared osteoporosis screening plus treatment versus treatment alone, incorporating standard fracture treatment and imaging costs ($66 for DEXA scans, $20 for chest X-rays).
In a sample of 1k women, AI-enhanced X-ray osteoporosis screening…
- Had an ICER of $72.1k per QALY, below the U.S. cost-effectiveness thresholds of $100k to $150k per QALY.
- Would produce healthcare savings of $99k, offset by treatment costs of $208k.
- Would prevent 2.8 fractures and increase QALYs by 1.5.
- Would remain cost-effective as long as AI’s cost did not exceed $62 per patient.
Adjusting the model’s parameters produced even better performance for AI-based screening.
- If medication adherence improved by 50%, the ICER was reduced to $28.6k.
The Takeaway
The new research offers more support for opportunistic osteoporosis screening, this time perhaps from the most important angle of all: cost-effectiveness. If confirmed with other studies, AI-based bone density analysis could make routine chest X-rays even more valuable.
