{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:02:17Z","timestamp":1790960537738,"version":"4.1.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can Assoc Radiol J"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Osteoporosis is an under-screened musculoskeletal disorder that results in diminished quality of life and significant burden to the healthcare system. We aimed to evaluate the ability of Rho, an artificial intelligence (AI) tool, to prospectively identify patients at-risk for low bone mineral density (BMD) from standard x-rays, its adoption rate by radiologists, and acceptance by primary care providers (PCPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients \u226550\u2009years were recruited when undergoing an x-ray of a Rho-eligible body part for any clinical indication. Questionnaires were completed at baseline and 6-month follow-up, and PCPs of \u201cRho-Positive\u201d patients (those likely to have low BMD) were asked for feedback. Positive predictive value (PPV) was calculated in patients who returned within 6\u2009months for a DXA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 1145 patients consented, 987 had x-rays screened by Rho, and 655 were flagged as Rho-Positive. Radiologists included this finding in 524 (80%) of reports. Of all Rho-Positive patients, 125 had a DXA within 6\u2009months; Rho had a 74% PPV for DXA T-Score &lt;\u22121. From 51 PCP responses, 78% found Rho beneficial. Of 389 patients with follow-up questionnaire data, a greater proportion of patients with Rho results reported vs not reported by a radiologist had discussed bone health with their PCP since study start (37% vs 21%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), or were newly diagnosed with osteoporosis (12% vs 5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>By identifying patients at-risk of low BMD, with acceptability of reporting by radiologists and generally positive feedback from PCPs, Rho has the potential to improve low screening rates for osteoporosis by leveraging existing x-ray data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08465371251380240","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T12:45:57Z","timestamp":1759149957000},"page":"348-353","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["AI Screening Tool Based on X-Rays Improves Early Detection of Decreased Bone Density in a Clinical Setting"],"prefix":"10.1177","volume":"77","author":[{"given":"Andrew N.","family":"Jayarajah","sequence":"first","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Atinga","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Probyn","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiru","family":"Sivakumaran","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Christakis","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6996-237X","authenticated-orcid":false,"given":"Anastasia","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Osteoporosis and Related Fractures in Canada: Report from the Canadian Chronic Disease Surveillance System, 2020","author":"Public Health Agency of Canada","year":"2024","unstructured":"Public Health Agency of Canada. Osteoporosis and Related Fractures in Canada: Report from the Canadian Chronic Disease Surveillance System, 2020. Public Health Agency of Canada; 2024."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(21)00172-0"},{"key":"e_1_3_3_4_2","unstructured":"International Society for Clinical Densitometry. 2019 ISCD official positions - adult. Accessed July 15 2025. https:\/\/iscd.org\/learn\/official-positions\/adult-positions\/"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.221647"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2022.2141483"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4821"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2023.07.024"},{"key":"e_1_3_3_9_2","unstructured":"U.S. Food and Drug Administration. Rho de novo summary. Accessed September 2 2025. https:\/\/www.accessdata.fda.gov\/cdrh_docs\/reviews\/DEN230023.pdf"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carj.2011.05.001"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-024-01446-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.compmedimag.2018.05.003"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.231937"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-024-01372-9"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2023.10.008"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4477"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-023-02030-2"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-025-07487-0"}],"container-title":["Canadian Association of Radiologists Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08465371251380240","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08465371251380240","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08465371251380240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:57:29Z","timestamp":1777384649000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08465371251380240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,29]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/08465371251380240"],"URL":"https:\/\/doi.org\/10.1177\/08465371251380240","relation":{},"ISSN":["0846-5371","1488-2361"],"issn-type":[{"value":"0846-5371","type":"print"},{"value":"1488-2361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,29]]}}}