Diagnostic accuracy & clinical importance of AI confidence for extremity fracture detection: 2,508-patient retrospective cohort
Abstract: Purpose To estimate diagnostic performance of a deep learning algorithm for extremity fracture detection on radiographs in patients aged ≥ 2 years using a refined reference standard. Secondary, to compare positive predictive value (PPV) by the algorithm's built-in confidence level (high vs. low) and diagnostic performance between adults (≥ 18 years) and children. Methods This retrospective single-center study consecutively included patients with radiography of a suspected extremity fracture between January and D…
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Purpose To estimate diagnostic performance of a deep learning algorithm for extremity fracture detection on radiographs in patients aged ≥ 2 years using a refined reference standard. Secondary, to compare positive predictive value (PPV) by the algorithm's built-in confidence level (high vs. low) and diagnostic performance between adults (≥ 18 years) and children.
The index test was the algorithm output (bounding boxes with confidence). Sensitivity, specificity, PPV and negative predictive value (NPV) were calculated with 95% confidence intervals; differences were tested using the McNemar and a score test and patient-clustered logistic regression.
- Purpose To estimate diagnostic performance of a deep learning algorithm for extremity fracture detection on radiographs in patients aged ≥ 2 years using a refined reference standard.
- Secondary, to compare positive predictive value (PPV) by the algorithm's built-in confidence level (high vs. low) and diagnostic performance between adults (≥ 18 years) and children.
- Methods This retrospective single-center study consecutively included patients with radiography of a suspected extremity fracture between January and December 2024.
PPV for high-confidence was superior to low-confidence detections (99.1% vs 59.1%, p Conclusion The algorithm showed good diagnostic performance for extremity fracture detection on radiographs.
The rundown
Methods This retrospective single-center study consecutively included patients with radiography of a suspected extremity fracture between January and December 2024. The index test was the algorithm output (bounding boxes with confidence).
Sources
- Peer-reviewedEmergency Radiology2026-09-22
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