Artificial intelligence is helping to spot fractures in Horton patients

Anyone who has a CT scan at the Horton General Hospital will be among the first in the country to benefit from artificial intelligence used to spot fractures.

The fracture prevention service at Oxford University Hospitals NHS Foundation Trust is the first unit in the UK to identify a bone weakening condition by using the technology.

Specialist nurse practitioners in fracture prevention and osteoporosis Sarah Connacher, left, and Rachel Eckert on World Osteoporosis Day in October, 2018. Photo: OUH

Specialist nurse practitioners in fracture prevention and osteoporosis Sarah Connacher, left, and Rachel Eckert on World Osteoporosis Day in October, 2018. Photo: OUH

The programme built by Zebra Medical means the team is able to detect osteoporotic vertebral fractures from all computed tomography scanners in its hospitals, including the Horton.

Sarah Connacher, a specialist nurse practitioner in fracture prevention and osteoporosis at the trust, said: “Using AI technology to detect vertebral fractures has been an exciting development to the already excellent fracture prevention service in Oxfordshire.

“This is something to be celebrated, not only for it being a nurse-led service but also for the significant advancement in care for vulnerable patients.”

Osteoporotic vertebral fractures occur when the struts that make up the mesh-like structure within bones become fragile and break easily following a minor injury or heavy lifting for example.

Pioneered by a nurse-led quality improvement project, this technology has resulted in significant advances in care for patients with osteoporosis, a condition which can often lead to a reduced quality of life.

Benefits include earlier detection of these fractures, which are often undiagnosed as patients are not even aware they have them.

While all patients with a fracture sustained following a fall from standing height who arrive at one of the trauma or emergency departments are assessed for their osteoporosis risk, patients with an osteoporotic vertebral fracture are often missed as they rarely go to and remain undiagnosed.

In addition to improving patient care, early identification and treatment of these fractures will result in savings for the NHS as a vertebral fracture can predict future fragility fractures, such as fractured hips and wrists.

The AI algorithm re-analyses the CT images of any OUH patient over the age of 50. The CT scans will have been carried out for reasons other than a vertebral fracture, meaning the software can identify vertebral fractures incidentally.

These scans are screened by the AI software and those positive for fracture are identified and analysed further by experienced nurses.

Using AI has helped the Oxford Fracture Liaison Service, based at the Nuffield Orthopaedic Centre, with its aim of identifying all patients with an osteoporotic vertebral fracture.

So far, more than 100 patients with a previously unknown osteoporotic vertebral fracture have been successfully identified, assessed, and put onto osteoporosis treatment by the team - thanks to the help of AI.

The team presented their work at the World Congress in Osteoporosis in Paris in April.

Zebra Medical, which sponsored the nurses to attend the conference, presented the nurses and rheumatologist Kassim Javaid with an award thank and highlight the success they have achieved.