{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:05:04Z","timestamp":1790323504287,"version":"4.1.0"},"reference-count":32,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004725","name":"Ministry of Economic Affairs ROC Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Osteoporosis and Sarcopenia"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.afos.2026.06.001","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:00:31Z","timestamp":1782446431000},"page":"23-31","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Federated learning for privacy-preserving opportunistic screening of lumbar-spine DXA-defined osteoporotic-level bone mineral density using chest radiographs: A multi-center independent validation study"],"prefix":"10.1016","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8301-9661","authenticated-orcid":false,"given":"Bo-Ru","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1853-4356","authenticated-orcid":false,"given":"Ming-Yueh","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chung","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Wei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2002-4228","authenticated-orcid":false,"given":"Paul","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5163-8712","authenticated-orcid":false,"given":"Wei-Chieh","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.afos.2026.06.001_bib1","first-page":"785","article-title":"NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy","volume":"285","year":"2001","journal-title":"JAMA"},{"key":"10.1016\/j.afos.2026.06.001_bib2","first-page":"283","article-title":"Bone mineral density in adults in Taiwan: results of the Nutrition and Health Survey in Taiwan 2005-2008 (NAHSIT 2005-2008)","volume":"20","author":"Lin","year":"2011","journal-title":"Asia Pac J Clin Nutr"},{"key":"10.1016\/j.afos.2026.06.001_bib3","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1002\/jbmr.2888","article-title":"A crisis in the treatment of osteoporosis","volume":"31","author":"Khosla","year":"2016","journal-title":"J Bone Miner Res"},{"key":"10.1016\/j.afos.2026.06.001_bib4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.bone.2017.01.033","article-title":"Quality in dual-energy X-ray absorptiometry scans","volume":"104","author":"Morgan","year":"2017","journal-title":"Bone"},{"key":"10.1016\/j.afos.2026.06.001_bib5","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s11657-017-0385-5","article-title":"Age- and gender-specific epidemiology, treatment patterns, and economic burden of osteoporosis and associated fracture in Taiwan between 2009 and 2013","volume":"12","author":"Wang","year":"2017","journal-title":"Arch Osteoporosis"},{"key":"10.1016\/j.afos.2026.06.001_bib6","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.crad.2005.04.016","article-title":"Medical imaging in pharmaceutical clinical trials: what radiologists should know","volume":"60","author":"Wang","year":"2005","journal-title":"Clin Radiol"},{"key":"10.1016\/j.afos.2026.06.001_bib7","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.3390\/diagnostics14121208","article-title":"Clinical validation of a deep learning-based software for lumbar bone mineral density and T-score prediction from chest X-ray images","volume":"14","author":"Tseng","year":"2024","journal-title":"Diagnostics"},{"key":"10.1016\/j.afos.2026.06.001_bib8","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3390\/diagnostics14020207","article-title":"Diagnostic accuracy of deep learning for the prediction of osteoporosis using plain X-rays: a systematic review and meta-analysis","volume":"14","author":"Yen","year":"2024","journal-title":"Diagnostics"},{"key":"10.1016\/j.afos.2026.06.001_bib9","unstructured":"Office for Civil Rights. Health information privacy (HIPAA) [Internet]. Washington, D.C.: U.S. Department of Health and Human Services [cited 2026 Feb 10]. Available from: https:\/\/www.hhs.gov\/hipaa\/index.html."},{"key":"10.1016\/j.afos.2026.06.001_bib10","first-page":"1","article-title":"2016\/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data (General Data Protection Regulation)","volume":"L119","year":"2016","journal-title":"Off J Eur Union"},{"key":"10.1016\/j.afos.2026.06.001_bib12","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1038\/s42256-020-0186-1","article-title":"Secure, privacy-preserving and federated machine learning in medical imaging","volume":"2","author":"Kaissis","year":"2020","journal-title":"Nat Mach Intell"},{"key":"10.1016\/j.afos.2026.06.001_bib13","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1109\/TBME.2021.3117407","article-title":"Domain adaptation for Medical Image Analysis: a Survey","volume":"69","author":"Guan","year":"2022","journal-title":"IEEE Trans Biomed Eng"},{"key":"10.1016\/j.afos.2026.06.001_bib14","first-page":"1273","article-title":"Communication-Efficient learning of deep networks from decentralized data","volume":"54","author":"McMahan","year":"2017","journal-title":"Proceedings of the 20th International Conference on Artificial Intelligence and Statistics (AISTATS)"},{"key":"10.1016\/j.afos.2026.06.001_bib15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jocd.2016.03.003","article-title":"Best practices for dual-energy X-ray absorptiometry measurement and reporting: International Society for Clinical Densitometry Guidance","volume":"19","author":"Lewiecki","year":"2016","journal-title":"J Clin Densitom"},{"key":"10.1016\/j.afos.2026.06.001_bib16","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/BF01622200","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report","volume":"4","author":"Kanis","year":"1994","journal-title":"Osteoporos Int"},{"key":"10.1016\/j.afos.2026.06.001_bib17","series-title":"Proceedings of the IEEE conference on computer vision and pattern recognition","first-page":"248","article-title":"ImageNet: a large-scale hierarchical image database","author":"Deng","year":"2009"},{"key":"10.1016\/j.afos.2026.06.001_bib18","series-title":"Proceedings of the IEEE\/CVF conference on computer vision and pattern recognition (CVPR)","first-page":"11976","article-title":"A ConvNet for the 2020s","author":"Liu","year":"2022"},{"key":"10.1016\/j.afos.2026.06.001_bib19","series-title":"In:International conference on learning representations (ICLR)","article-title":"Decoupled weight decay regularization","author":"Loshchilov","year":"2019"},{"key":"10.1016\/j.afos.2026.06.001_bib20","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"Youden","year":"1950","journal-title":"Cancer"},{"key":"10.1016\/j.afos.2026.06.001_bib21","year":"2022","journal-title":"Food and Drug Administration, Center for Devices and Radiological Health"},{"key":"10.1016\/j.afos.2026.06.001_bib22","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics"},{"key":"10.1016\/j.afos.2026.06.001_bib23","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/biomet\/26.4.404","article-title":"The use of confidence or fiducial limits illustrated in the case of the binomial","volume":"26","author":"Clopper","year":"1934","journal-title":"Biometrika"},{"key":"10.1016\/j.afos.2026.06.001_bib24","series-title":"R: A language and environment for statistical computing [Internet]","year":"2020"},{"key":"10.1016\/j.afos.2026.06.001_bib25","series-title":"In: Proceedings of the IEEE International Conference on Computer Vision","first-page":"618","article-title":"Grad-CAM: visual explanations from deep networks via gradient-based localization","author":"Selvaraju","year":"2017"},{"key":"10.1016\/j.afos.2026.06.001_bib26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/jbmr.4477","article-title":"Opportunistic osteoporosis screening using chest radiographs with deep learning: development and external validation with a cohort dataset","volume":"37","author":"Jang","year":"2022","journal-title":"J Bone Miner Res"},{"key":"10.1016\/j.afos.2026.06.001_bib27","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1136\/bmj.1.5641.409","article-title":"Width of clavicular cortex in osteoporosis","volume":"1","author":"Anton","year":"1969","journal-title":"Br Med J"},{"key":"10.1016\/j.afos.2026.06.001_bib28","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s40618-014-0074-9","article-title":"The role of hip and chest radiographs in osteoporotic evaluation among south Indian women population: a comparative scenario with DXA","volume":"37","author":"Kumar","year":"2014","journal-title":"J Endocrinol Investig"},{"key":"10.1016\/j.afos.2026.06.001_bib29","series-title":"2025 Taiwan Consensus and Guidelines for the prevention and treatment of osteoporosis. Taipei","year":"2025"},{"key":"10.1016\/j.afos.2026.06.001_bib30","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.afos.2025.10.003","article-title":"Cost-effectiveness of opportunistic osteoporosis screening using artificial-intelligence assisted chest radiographs in Japan","volume":"11","author":"Reginster","year":"2025","journal-title":"Osteoporos Sarcopenia"},{"key":"10.1016\/j.afos.2026.06.001_bib31","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1210\/jcem-70-4-1202","article-title":"The impact of osteophytic and vascular calcifications on vertebral mineral density","volume":"70","author":"Orwoll","year":"1990","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.afos.2026.06.001_bib32","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1210\/jcem-72-6-1372","article-title":"The influence of osteophytes and aortic calcification on spinal mineral density in postmenopausal women","volume":"72","author":"Reid","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.afos.2026.06.001_bib33","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00198-007-0543-5","article-title":"FRAX and the assessment of fracture probability in men and women from the UK","volume":"19","author":"Kanis","year":"2008","journal-title":"Osteoporos Int"}],"container-title":["Osteoporosis and Sarcopenia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405525526000440?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405525526000440?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:36:50Z","timestamp":1790321810000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405525526000440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S2405525526000440"],"URL":"https:\/\/doi.org\/10.1016\/j.afos.2026.06.001","relation":{},"ISSN":["2405-5255"],"issn-type":[{"value":"2405-5255","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Federated learning for privacy-preserving opportunistic screening of lumbar-spine DXA-defined osteoporotic-level bone mineral density using chest radiographs: A multi-center independent validation study","name":"articletitle","label":"Article Title"},{"value":"Osteoporosis and Sarcopenia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.afos.2026.06.001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Korean Society of Osteoporosis. Publishing services by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}