Abstract
Hip fractures are a major cause of morbidity and mortality in the elderly, and incur high health and social care costs. Given projected population ageing, the number of incident hip fractures is predicted to increase globally. As fracture classification strongly determines the chosen surgical treatment, differences in fracture classification influence patient outcomes and treatment costs. We aimed to create a machine learning method for identifying and classifying hip fractures, and to compare its performance to experienced human observers. We used 3659 hip radiographs, classified by at least two expert clinicians. The machine learning method was able to classify hip fractures with 19% greater accuracy than humans, achieving overall accuracy of 92%.
Highlights
Hip fractures are a major cause of morbidity and mortality in the elderly, and incur high health and social care costs
We observed area under the ROC curve (AUC) of 0.98 for “No fracture”, 0.99 for “Trochanteric” and 0.97 for “Intracapsular”
We have demonstrated that a trained neural network can classify hip fractures with 19% increased accuracy compared to human observers with experience of hip fracture classification in a clinical setting
Summary
Hip fractures are a major cause of morbidity and mortality in the elderly, and incur high health and social care costs. The number of incident hip fractures is predicted to increase globally. Hip fractures are a major cause of morbidity and mortality for the elderly, and incur high direct health c osts[1]. The choice of intervention for a given fracture type predicts the risk of death following s urgery[20] Governance bodies such as the National Institute for Health and Care Excellence (NICE) place great emphasis on the choice of operation and implant that should be offered for different hip fracture types, reflecting both the Scientific Reports | (2022) 12:2058. Trochanteric evidence-base and the potential cost of some implant types[13], such that NICE compliant surgery is one of the six key performance indicators for the provision of hip fracture care in the UK7
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