Gupta Amit, Maslen Christina, Vindlacheruvu Madhavi, Abel Richard L, Bhattacharya Pinaki, Bromiley Paul A, Clark Emma M, Compston Juliet E, Crabtree Nicola, Gregory Jennifer S, Kariki Eleni P, Harvey Nicholas C, McCloskey Eugene, Ward Kate A, Poole Kenneth E S
Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Health Evidence Matters, Bristol, UK.
Ther Adv Musculoskelet Dis. 2022 Mar 28;14:1759720X221083523. doi: 10.1177/1759720X221083523. eCollection 2022.
The growing burden from osteoporosis and fragility fractures highlights a need to improve osteoporosis management across healthcare systems. Sub-optimal management of osteoporosis is an area suitable for digital health interventions. While fracture liaison services (FLSs) are proven to greatly improve care for people with osteoporosis, such services might benefit from technologies that enhance automation. The term 'Digital Health' covers a variety of different tools including clinical decision support systems, electronic medical record tools, patient decision aids, patient apps, education tools, and novel artificial intelligence (AI) algorithms. Within the scope of this review are AI solutions that use algorithms within health system registries to target interventions. Clinician-targeted, patient-targeted, or system-targeted digital health interventions could be used to improve management and prevent fragility fractures. This review was commissioned by The Royal Osteoporosis Society and Bone Research Academy during the production of the 2020 Research Roadmap (https://theros.org.uk), with the intention of identifying gaps where targeted research funding could lead to improved patient health. We explore potential uses of digital technology in the general management of osteoporosis. Evidence suggests that digital technologies can support multidisciplinary teams to provide the best possible patient care based on current evidence and to support patients in self-management. However, robust randomised controlled studies are still needed to assess the effectiveness and cost-effectiveness of these technologies.
骨质疏松症和脆性骨折带来的负担日益加重，凸显出改善整个医疗系统中骨质疏松症管理的必要性。骨质疏松症管理欠佳是适合进行数字健康干预的领域。虽然骨折联络服务（FLS）已被证明能极大地改善对骨质疏松症患者的护理，但此类服务可能会从增强自动化的技术中受益。“数字健康”一词涵盖各种不同工具，包括临床决策支持系统、电子病历工具、患者决策辅助工具、患者应用程序、教育工具以及新型人工智能（AI）算法。本综述范围内的AI解决方案是指在卫生系统登记处使用算法来确定干预目标。针对临床医生、患者或系统的数字健康干预措施可用于改善管理并预防脆性骨折。本综述由英国皇家骨质疏松症协会和骨研究学院在制定2020年研究路线图（https://theros.org.uk）期间委托进行，目的是找出有针对性的研究资金可改善患者健康的差距。我们探讨数字技术在骨质疏松症总体管理中的潜在用途。有证据表明，数字技术可以支持多学科团队根据现有证据提供尽可能最佳的患者护理，并支持患者进行自我管理。然而，仍需要强有力的随机对照研究来评估这些技术的有效性和成本效益。
