scholarly journals A New Fracture Liaison Service Design Using a Mobile Application and Medical Artificial Intelligence (Preprint)

2018 ◽  
Author(s):  
Sung Woo Kim ◽  
Young Jun Won
Keyword(s):  
Mobile Application ◽  
Osteoporotic Fractures ◽  
Fracture Prevention ◽  
Fracture Liaison Service ◽  
Secondary Fracture ◽  
Secondary Fracture Prevention ◽  
Open Policy ◽  
Android Os ◽  
Secondary Fractures ◽  
Fracture Liaison

BACKGROUND While the clinical design of a Fracture Liaison Service(FLS) has been used as a localized healthcare service in a previous study, thus far there has not been an international mobile application, such as a FLS using smart phones. OBJECTIVE The goal of our study is to improve the prevention of secondary fractures using a Mobile FLS Application. METHODS We have developed a Fracture Liaison Service as an Android-OS application and released this service as a secondary fracture prevention program for osteoporotic fracture patients. RESULTS We have released the final version of the FLS mobile application in Google’s PlayStore. The new model of the FLS mobile application can be practically commercialized, and the effective second-order fracture prevention system is based on an open policy platform. CONCLUSIONS We hope to contribute to the prevention and management of osteoporotic fractures and osteoporosis worldwide via this FLS mobile application. In the future, an intelligent personal FLS is definitely possible, by applying a Medical AI based on a huge DB.

scholarly journals Detection of vertebral fracture in an acute hospital setting: an intervention to reduce future fracture risk through fracture liaison service intervention?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Michael Toal ◽  
Connor McLoughlin ◽  
Nicole Pierce ◽  
Julie Moss ◽  
Sarah English ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Bone Density ◽  
Vertebral Fractures ◽  
Fracture Prevention ◽  
Fracture Liaison Service ◽  
Radiology Department ◽  
Secondary Fracture ◽  
Secondary Fracture Prevention ◽  
Prevention Services ◽  
Fracture Liaison

Abstract Summary We introduced a standardised reporting system in the radiology department to highlight vertebral fractures and to signpost fracture prevention services. Our quality improvement project achieved improved fracture reporting, access to the FLS service, bone density assessment and anti-fracture treatment. Purpose Identification of vertebral fragility fractures (VF) provides an opportunity to identify individuals at high risk who might benefit from secondary fracture prevention. We sought to standardise VF reporting and to signpost fracture prevention services. Our aim was to improve rates of VF detection and access to our fracture liaison service (FLS). Methods We introduced a standardised reporting tool within the radiology department to flag VFs with signposting for referral for bone densitometry (DXA) and osteoporosis assessment in line with Royal Osteoporosis Society guidelines. We monitored uptake of VF reporting during a quality improvement phase and case identification within the FLS service. Results Recruitment of individuals with VF to the FLS service increased from a baseline of 63 cases in 2017 (6%) to 95 (8%) in 2018 and 157 (8%) in 2019 and to 102 (12%) in the first 6 months of 2020 (p = 0.001). One hundred fifty-three patients with VFs were identified during the QI period (56 males; 97 females). Use of the terminology ‘fracture’ increased to 100% (mean age 70 years; SD 13) in computed tomography (n = 110), plain X-ray (n = 37) or magnetic resonance imaging (n = 6) reports within the cohort. Signposting to DXA and osteoporosis assessment was included in all reports (100%). DXA was arranged for 103/153; 12 failed to attend. Diagnostic categories were osteoporosis (31%), osteopenia (36%) or normal bone density (33%). A new prescription for bone protection therapy was issued in 63/153. Twelve of the series died during follow-up. Conclusions Standardisation of radiology reporting systems facilitates reporting of prevalent vertebral fractures and supports secondary fracture prevention strategies.

scholarly journals First results of the register of patients with osteoporosis included in the secondary fracture prevention services

2021 ◽  
pp. 211-218
Author(s):  
K. Yu. Belova ◽  
E. V. Bublik ◽  
E. N. Gladkova ◽  
H. G. Gordjeladze ◽  
E. N. Dudinskaya ◽  
...  
Keyword(s):  
Osteoporotic Fractures ◽  
Fracture Prevention ◽  
Fracture Liaison Service ◽  
International Standards ◽  
Secondary Fracture ◽  
Secondary Fracture Prevention ◽  
Prevention Services ◽  
First Results ◽  
Risk Of Falls ◽  
Processing Information

Background. To reduce the number of osteoporotic fractures in the world in recent years, — Fracture Liaison Service has been created. Since 2019, the development of a register of patients included in the Secondary Fracture Prevention named «Prometheus» has begun in Russia.Materials and methods. An information system for storing, searching and processing information has been created, and a registration card has been developed. Six FLS participate in the register management. As of 10.03.2021, data on 387 patients were introduced in the register.Results. Among the included patients, 46.25% received a fracture of the proximal femur, 20.41% — of the vertebral bodies and 16.80% of the proximal humerus, the rest had fractures of other localizations. The risk of fractures was assessed in all patients. A high risk of major osteoporotic fractures according to FRAX was determined in 160 (43.24%) people. Two-energy X-ray absorptiometry (DXA) was performed in 152 (39.28%) patients, and osteoporosis was detected in 103 (67.76%), osteopenia — in 42 (27.63%) patients. The risk of falls was assessed in 100% of the included patients, and the risk of falls was determined to be high in 343 (88.63%) patients. Evaluation of various laboratory parameters to find the causes of secondary osteoporosis was performed in most patients. After consultation with the FLS doctor, anti-osteoporotic drugs were prescribed to 241 (64.27%) people. Among the rest, 70 (52.24%) patients had contra-indications and 31 (23.13%) people needed further examination.Conclusions. Thus, the use of the register allows you to evaluate all the main sections of the organization of assistance within the FLS and compare them with international standards to identify «gaps» and improve the work of the service.

scholarly journals Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Laurna Bullock ◽  
Fay Crawford-Manning ◽  
Elizabeth Cottrell ◽  
Jane Fleming ◽  
Sarah Leyland ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Evidence Synthesis ◽  
Fracture Prevention ◽  
Fracture Liaison Service ◽  
Delphi Survey ◽  
Shared Decision ◽  
Secondary Fracture ◽  
Drug Treatments ◽  
Fracture Liaison

Abstract Summary Fracture Liaison Services are recommended to deliver best practice in secondary fracture prevention. This modified Delphi survey, as part of the iFraP (Improving uptake of Fracture Prevention drug Treatments) study, provides consensus regarding tasks for clinicians in a model Fracture Liaison Service consultation. Purpose The clinical consultation is of pivotal importance in addressing barriers to treatment adherence. The aim of this study was to agree to the content of the ‘model Fracture Liaison Service (FLS) consultation’ within the iFraP (Improving uptake of Fracture Prevention drug Treatments) study. Methods A Delphi survey was co-designed with patients and clinical stakeholders using an evidence synthesis of current guidelines and content from frameworks and theories of shared decision-making, communication and medicine adherence. Patients with osteoporosis and/or fragility fractures, their carers, FLS clinicians and osteoporosis specialists were sent three rounds of the Delphi survey. Participants were presented with potential consultation content and asked to rate their perception of the importance of each statement on a 5-point Likert scale and to suggest new statements (Round 1). Lowest rated statements were removed or amended after Rounds 1 and 2. In Round 3, participants were asked whether each statement was ‘essential’ and percentage agreement calculated; the study team subsequently determined the threshold for essential content. Results Seventy-two, 49 and 52 patients, carers and clinicians responded to Rounds 1, 2 and 3 respectively. One hundred twenty-two statements were considered. By Round 3, consensus was reached, with 81 statements deemed essential within FLS consultations, relating to greeting/introductions; gathering information; considering therapeutic options; eliciting patient perceptions; establishing shared decision-making preferences; sharing information about osteoporosis and treatments; checking understanding/summarising; and signposting next steps. Conclusions This Delphi consensus exercise has summarised for the first time patient/carer and clinician consensus regarding clearly defined tasks for clinicians in a model FLS consultation.

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