{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T06:06:56Z","timestamp":1792822016678,"version":"4.5.0"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fragility fractures lead to considerable societal costs and individual suffering. Despite the availability of cost-effective treatments for high-risk patients, a significant treatment gap exists, with many high-risk individuals remaining unidentified and untreated. The aim of this study was to explore the potential cost-effectiveness and societal impact of opportunistic screening for fracture risk with IBEX Bone Health (BH), a software solution that provides bone mineral density from wrist radiographs, in a UK general radiography setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study used a health economic model that compared the health outcomes and costs of screening with IBEX BH versus usual care for men and women aged 50 and older who had a forearm radiograph for any reason. The model incorporated data on fracture incidence, fracture risk reduction, mortality, quality of life, and fracture and treatment costs from published sources and Royal Cornwall Hospitals NHS Trust. Costs and health outcomes in terms of quality-adjusted life years (QALYs) were simulated over the remaining lifetime of patients. The analysis took the perspective of the National Health Service (NHS) and Personal Social Services in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results showed that screening with IBEX BH was associated with a gain of 0.013 QALYs and a cost saving of \u00a3109 per patient compared with usual care, making it a dominant (cost-saving) strategy. Sensitivity analyses confirmed the robustness of the results under various assumptions. Widespread adoption of IBEX BH in the NHS was estimated to save 8,066 QALYs and \u00a365,930,555 in healthcare costs over the lifetime of patients visiting hospitals for wrist radiographs each year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IBEX BH could be a cost-effective tool for early identification and prevention of fragility fractures in the UK, addressing the current challenges of low provision and access to fracture risk assessment and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12891-024-08202-6","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:42:19Z","timestamp":1738647739000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring the potential cost-effectiveness and societal burden implications of screening for fracture risk in a UK general radiography setting"],"prefix":"10.1186","volume":"26","author":[{"given":"E.","family":"S\u00f6reskog","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Ashley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Da Palma Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Meertens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ratcliffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"issue":"1","key":"8202_CR1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s11657-020-0706-y","volume":"15","author":"F Borgstrom","year":"2020","unstructured":"Borgstrom F, Karlsson L, Ortsater G, Norton N, Halbout P, Cooper C, et al. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos. 2020;15(1):59.","journal-title":"Arch Osteoporos"},{"issue":"1","key":"8202_CR2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s11657-013-0137-0","volume":"8","author":"A Svedbom","year":"2013","unstructured":"Svedbom A, Hernlund E, Ivergard M, Compston J, Cooper C, Stenmark J, et al. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. 2013;8(1):137.","journal-title":"Arch Osteoporos"},{"issue":"1","key":"8202_CR3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s11657-020-00871-9","volume":"16","author":"JA Kanis","year":"2021","unstructured":"Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, et al. SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos. 2021;16(1):82.","journal-title":"Arch Osteoporos"},{"issue":"5","key":"8202_CR4","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1093\/qjmed\/hcz271","volume":"113","author":"K Hoggard","year":"2020","unstructured":"Hoggard K, Hart S, Birchall J, Kirk S, Goff I, Grove M, et al. Fracture prevention: a population-based intervention delivered in primary care. QJM. 2020;113(5):313\u20139.","journal-title":"QJM"},{"key":"8202_CR5","unstructured":"National Institute of Health and Care Excellence (NICE). Osteoporosis: assessing the risk of fragility fracture Clinical guideline (CG146). [Internet] ISBN 978\u20131\u20134731\u20132359\u20135. Available from: https:\/\/www.nice.org.uk\/Guidance\/CG146. 2017."},{"key":"8202_CR6","unstructured":"National Osteoporosis Guideline Group UK (NOGG). Clinical Guideline for the Prevention and Treatment of Osteoporosis. [Internet] Available from: https:\/\/www.nogg.org.uk\/full-guideline 2021."},{"key":"8202_CR7","unstructured":"Royal College of Physicians (RCP). Fracture Liaison Service Database (FLS-DB) Annual report: Improved FLS identification with gaps in monitoring: a call to action for national and regional planners. [Internet] ISBN 978\u20131\u201386016\u2013882\u20136. Available from: https:\/\/www.fffap.org.uk\/fls\/flsweb.nsf\/docs\/DownloadFiles\/$File\/FLS-DB%202024%20annual%20report.pdf?openelement. London, England; 2024."},{"issue":"8","key":"8202_CR8","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1016\/j.injury.2018.06.031","volume":"49","author":"P Mitchell","year":"2018","unstructured":"Mitchell P, \u00c5kesson K. How to prevent the next fracture. Injury. 2018;49(8):1424\u20139.","journal-title":"Injury"},{"issue":"3 Suppl","key":"8202_CR9","doi-asserted-by":"publisher","first-page":"e198","DOI":"10.1097\/OI9.0000000000000198","volume":"5","author":"TJS Chesser","year":"2022","unstructured":"Chesser TJS, Javaid MK, Mohsin Z, Pari C, Belluati A, Contini A, et al. Overview of fracture liaison services in the UK and Europe: standards, model of care, funding, and challenges. OTA Int. 2022;5(3 Suppl):e198.","journal-title":"OTA Int"},{"key":"8202_CR10","unstructured":"Royal College of Physicians (RCP). Fracture Liaison Service Database (FLS-DB) Annual Report 2023. [Internet] ISBN 978\u20131\u201386016\u2013875\u20138. Available from: https:\/\/www.rcplondon.ac.uk\/projects\/outputs\/fls-db-annual-report-2023. London, England; 2023."},{"issue":"12","key":"8202_CR11","doi-asserted-by":"publisher","first-page":"e051021","DOI":"10.1136\/bmjopen-2021-051021","volume":"11","author":"A Rangan","year":"2021","unstructured":"Rangan A, Tuck SP, Scott PD, Kottam L, Jafari M, Watson T, et al. Prospective comparative study of quantitative X-ray (QXR) versus dual energy X-ray absorptiometry to determine the performance of QXR as a predictor of bone health for adult patients in secondary care. BMJ Open. 2021;11(12):e051021.","journal-title":"BMJ Open"},{"issue":"1","key":"8202_CR12","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1186\/s12891-024-07670-0","volume":"25","author":"B Lopez","year":"2024","unstructured":"Lopez B, Meertens R, Gundry M, Scott P, Crone MB, McWilliam R. A comparison between IBEX bone health applied to digital radiographs and dual-energy X-ray absorptiometry at the distal-third and ultra-distal regions of the radius. BMC Musculoskelet Disord. 2024;25(1):575.","journal-title":"BMC Musculoskelet Disord"},{"issue":"4","key":"8202_CR13","doi-asserted-by":"publisher","first-page":"ziae020","DOI":"10.1093\/jbmrpl\/ziae020","volume":"8","author":"R Meertens","year":"2024","unstructured":"Meertens R, Lopez B, Crone B, Gundry M, Metcalfe-Smith E, Gibbard W, et al. Development of an opportunistic diagnostic prediction algorithm for osteoporosis and fragility fracture risk estimates from forearm radiographs (The OFFER1 Study). JBMR Plus. 2024;8(4):ziae020.","journal-title":"JBMR Plus."},{"issue":"1","key":"8202_CR14","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s00198-006-0257-0","volume":"18","author":"N Zethraeus","year":"2007","unstructured":"Zethraeus N, Borgstrom F, Strom O, Kanis JA, Jonsson B. Cost-effectiveness of the treatment and prevention of osteoporosis\u2013a review of the literature and a reference model. Osteoporos Int. 2007;18(1):9\u201323.","journal-title":"Osteoporos Int"},{"issue":"3","key":"8202_CR15","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1007\/s00198-010-1424-x","volume":"22","author":"B Jonsson","year":"2011","unstructured":"Jonsson B, Strom O, Eisman JA, Papaioannou A, Siris ES, Tosteson A, et al. Cost-effectiveness of Denosumab for the treatment of postmenopausal osteoporosis. Osteoporos Int. 2011;22(3):967\u201382.","journal-title":"Osteoporos Int"},{"issue":"11","key":"8202_CR16","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1007\/s00198-004-1643-0","volume":"15","author":"JA Kanis","year":"2004","unstructured":"Kanis JA, Borgstrom F, Johnell O, Jonsson B. Cost-effectiveness of risedronate for the treatment of osteoporosis and prevention of fractures in postmenopausal women. Osteoporos Int. 2004;15(11):862\u201371.","journal-title":"Osteoporos Int"},{"issue":"1","key":"8202_CR17","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.bone.2007.10.019","volume":"42","author":"JA Kanis","year":"2008","unstructured":"Kanis JA, Adams J, Borgstrom F, Cooper C, Jonsson B, Preedy D, et al. The cost-effectiveness of alendronate in the management of osteoporosis. Bone. 2008;42(1):4\u201315.","journal-title":"Bone"},{"issue":"2","key":"8202_CR18","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1302\/0301-620X.80B2.0800243","volume":"80","author":"BR Singer","year":"1998","unstructured":"Singer BR, McLauchlan GJ, Robinson CM, Christie J. Epidemiology of fractures in 15,000 adults: the influence of age and gender. J Bone Joint Surg Br. 1998;80(2):243\u20138.","journal-title":"J Bone Joint Surg Br"},{"issue":"1","key":"8202_CR19","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/s11657-013-0136-1","volume":"8","author":"E Hernlund","year":"2013","unstructured":"Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8(1):136.","journal-title":"Arch Osteoporos."},{"issue":"7041","key":"8202_CR20","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1136\/bmj.312.7041.1254","volume":"312","author":"D Marshall","year":"1996","unstructured":"Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996;312(7041):1254\u20139.","journal-title":"BMJ"},{"issue":"5","key":"8202_CR21","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1007\/s001980050093","volume":"8","author":"AC Looker","year":"1998","unstructured":"Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, et al. Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998;8(5):468\u201389.","journal-title":"Osteoporos Int"},{"issue":"4","key":"8202_CR22","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1359\/jbmr.2000.15.4.721","volume":"15","author":"CM Klotzbuecher","year":"2000","unstructured":"Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721\u201339.","journal-title":"J Bone Miner Res"},{"issue":"2","key":"8202_CR23","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.bone.2004.03.024","volume":"35","author":"JA Kanis","year":"2004","unstructured":"Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35(2):375\u201382.","journal-title":"Bone"},{"issue":"10","key":"8202_CR24","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1007\/s00198-023-06837-0","volume":"34","author":"EH Tan","year":"2023","unstructured":"Tan EH, Robinson DE, Jodicke AM, Mosseveld M, Bodkergaard K, Reyes C, et al. Drug utilization analysis of osteoporosis medications in seven European electronic health databases. Osteoporos Int. 2023;34(10):1771\u201381.","journal-title":"Osteoporos Int"},{"issue":"29","key":"8202_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta24290","volume":"24","author":"S Davis","year":"2020","unstructured":"Davis S, Simpson E, Hamilton J, James MM, Rawdin A, Wong R, et al. Denosumab, raloxifene, romosozumab and teriparatide to prevent osteoporotic fragility fractures: a systematic review and economic evaluation. Health Technol Assess. 2020;24(29):1\u2013314.","journal-title":"Health Technol Assess"},{"issue":"8","key":"8202_CR26","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1007\/s00198-006-0322-8","volume":"18","author":"JA Cramer","year":"2007","unstructured":"Cramer JA, Gold DT, Silverman SL, Lewiecki EM. A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int. 2007;18(8):1023\u201331.","journal-title":"Osteoporos Int"},{"issue":"11","key":"8202_CR27","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1007\/s00198-020-05507-9","volume":"31","author":"G Koller","year":"2020","unstructured":"Koller G, Goetz V, Vandermeer B, Homik J, McAlister FA, Kendler D, et al. Persistence and adherence to parenteral osteoporosis therapies: a systematic review. Osteoporos Int. 2020;31(11):2093\u2013102.","journal-title":"Osteoporos Int"},{"issue":"3","key":"8202_CR28","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s00198-019-05228-8","volume":"31","author":"J Morley","year":"2020","unstructured":"Morley J, Moayyeri A, Ali L, Taylor A, Feudjo-Tepie M, Hamilton L, et al. Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK clinical practice research datalink. Osteoporos Int. 2020;31(3):533\u201345.","journal-title":"Osteoporos Int"},{"issue":"24","key":"8202_CR29","doi-asserted-by":"publisher","first-page":"2927","DOI":"10.1001\/jama.296.24.2927","volume":"296","author":"DM Black","year":"2006","unstructured":"Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, et al. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA. 2006;296(24):2927\u201338.","journal-title":"JAMA"},{"issue":"2","key":"8202_CR30","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1002\/jbmr.1494","volume":"27","author":"DM Black","year":"2012","unstructured":"Black DM, Reid IR, Boonen S, Bucci-Rechtweg C, Cauley JA, Cosman F, et al. The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012;27(2):243\u201354.","journal-title":"J Bone Miner Res"},{"issue":"18","key":"8202_CR31","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1001\/archinte.164.18.2024","volume":"164","author":"R Lindsay","year":"2004","unstructured":"Lindsay R, Scheele WH, Neer R, Pohl G, Adami S, Mautalen C, et al. Sustained vertebral fracture risk reduction after withdrawal of teriparatide in postmenopausal women with osteoporosis. Arch Intern Med. 2004;164(18):2024\u201330.","journal-title":"Arch Intern Med"},{"issue":"9","key":"8202_CR32","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1359\/JBMR.050501","volume":"20","author":"R Prince","year":"2005","unstructured":"Prince R, Sipos A, Hossain A, Syversen U, Ish-Shalom S, Marcinowska E, et al. Sustained nonvertebral fragility fracture risk reduction after discontinuation of teriparatide treatment. J Bone Miner Res. 2005;20(9):1507\u201313.","journal-title":"J Bone Miner Res"},{"key":"8202_CR33","unstructured":"Office for National Statistics (ONS). National life tables: United Kingdom 2020\u20132022. [Internet] Available from: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/lifeexpectancies\/datasets\/nationallifetablesunitedkingdomreferencetables. 2024."},{"issue":"5","key":"8202_CR34","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1111\/j.1524-4733.2010.00700.x","volume":"13","author":"R Ara","year":"2010","unstructured":"Ara R, Brazier JE. Populating an economic model with health state utility values: moving toward better practice. Value Health. 2010;13(5):509\u201318.","journal-title":"Value Health"},{"issue":"3","key":"8202_CR35","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s00198-017-4317-4","volume":"29","author":"A Svedbom","year":"2018","unstructured":"Svedbom A, Borgstom F, Hernlund E, Strom O, Alekna V, Bianchi ML, et al. Quality of life for up to 18 months after low-energy hip, vertebral, and distal forearm fractures-results from the ICUROS. Osteoporos Int. 2018;29(3):557\u201366.","journal-title":"Osteoporos Int"},{"issue":"8","key":"8202_CR36","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.1007\/s00198-018-4502-0","volume":"29","author":"JA Kanis","year":"2018","unstructured":"Kanis JA, Johansson H, Oden A, Harvey NC, Gudnason V, Sanders KM, et al. Characteristics of recurrent fractures. Osteoporos Int. 2018;29(8):1747\u201357.","journal-title":"Osteoporos Int"},{"issue":"5","key":"8202_CR37","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1023\/A:1015632114068","volume":"11","author":"J Tidermark","year":"2002","unstructured":"Tidermark J, Zethraeus N, Svensson O, Tornkvist H, Ponzer S. Femoral neck fractures in the elderly: functional outcome and quality of life according to EuroQol. Qual Life Res. 2002;11(5):473\u201381.","journal-title":"Qual Life Res"},{"issue":"1","key":"8202_CR38","doi-asserted-by":"publisher","first-page":"99","DOI":"10.3111\/13696998.2010.547967","volume":"14","author":"L Gutierrez","year":"2011","unstructured":"Gutierrez L, Roskell N, Castellsague J, Beard S, Rycroft C, Abeysinghe S, et al. Study of the incremental cost and clinical burden of hip fractures in postmenopausal women in the United Kingdom. J Med Econ. 2011;14(1):99\u2013107.","journal-title":"J Med Econ"},{"issue":"3","key":"8202_CR39","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.bone.2012.05.020","volume":"51","author":"L Gutierrez","year":"2012","unstructured":"Gutierrez L, Roskell N, Castellsague J, Beard S, Rycroft C, Abeysinghe S, et al. Clinical burden and incremental cost of fractures in postmenopausal women in the United Kingdom. Bone. 2012;51(3):324\u201331.","journal-title":"Bone"},{"issue":"7","key":"8202_CR40","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/j.injury.2014.02.005","volume":"45","author":"SK Nanjayan","year":"2014","unstructured":"Nanjayan SK, John J, Swamy G, Mitsiou K, Tambe A, Abuzakuk T. Predictors of change in \u201cdischarge destination\u201d following treatment for fracture neck of femur. Injury. 2014;45(7):1080\u20134.","journal-title":"Injury"},{"key":"8202_CR41","unstructured":"Jones K, Weatherly H, Birch S, Castelli A, Chalkley M, Dargan A, et al. Unit costs of health and social care 2022 University of Kent 2022."},{"key":"8202_CR42","unstructured":"National Institute for Health and Care Excellence (NICE). NICE health technology evaluations: the manual PMG36. [Internet] ISBN: 978\u20131\u20134731\u20135663\u20130. Available from: https:\/\/www.nice.org.uk\/process\/pmg36. 2022."},{"key":"8202_CR43","unstructured":"Royal College of Physicians (RCP). National Hip Fracture Database Annual Report 2023 [Internet]. Available from: https:\/\/www.nhfd.co.uk\/20\/hipfractureR.nsf\/docs\/2023Report. London, England; 2024."},{"issue":"4","key":"8202_CR44","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1383\/wohm.2006.3.4.149","volume":"3","author":"MD Stevenson","year":"2006","unstructured":"Stevenson MD, Davis SE, Kanis JA. The hospitalisation costs and out-patient costs of fragility fractures. Women\u2019s Health Med. 2006;3(4):149\u201351.","journal-title":"Women's Health Med"},{"key":"8202_CR45","unstructured":"DH\/SC LG & CP directorate\/Older People and Dementia. Fracture Prevention Services: an economic evaluation. [Internet] Available from: 2009."},{"issue":"7","key":"8202_CR46","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1007\/s00198-011-1534-0","volume":"22","author":"AR McLellan","year":"2011","unstructured":"McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, et al. Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int. 2011;22(7):2083\u201398.","journal-title":"Osteoporos Int"},{"issue":"10122","key":"8202_CR47","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/S0140-6736(17)32640-5","volume":"391","author":"L Shepstone","year":"2018","unstructured":"Shepstone L, Lenaghan E, Cooper C, Clarke S, Fong-Soe-Khioe R, Fordham R, et al. Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. Lancet. 2018;391(10122):741\u20137.","journal-title":"Lancet"},{"issue":"5","key":"8202_CR48","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1002\/jbmr.3381","volume":"33","author":"DA Turner","year":"2018","unstructured":"Turner DA, Khioe RFS, Shepstone L, Lenaghan E, Cooper C, Gittoes N, et al. The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study. J Bone Miner Res. 2018;33(5):845\u201351.","journal-title":"J Bone Miner Res"},{"issue":"7","key":"8202_CR49","doi-asserted-by":"publisher","first-page":"e0220148","DOI":"10.1371\/journal.pone.0220148","volume":"14","author":"L Li","year":"2019","unstructured":"Li L, Severens JLH, Mandrik O. Disutility associated with cancer screening programs: a systematic review. PLoS ONE. 2019;14(7):e0220148.","journal-title":"PLoS ONE"},{"issue":"6","key":"8202_CR50","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1016\/j.radi.2023.08.011","volume":"29","author":"F Manning","year":"2023","unstructured":"Manning F, Mahmoud A, Meertens R. Understanding patient views and acceptability of predictive software in osteoporosis identification. Radiography (Lond). 2023;29(6):1046\u201353.","journal-title":"Radiography (Lond)"},{"key":"8202_CR51","unstructured":"National Health Service England. Diagnostic waiting times and activity. Monthly diagnostics data February 2024. [Internet] Available from: https:\/\/www.england.nhs.uk\/statistics\/statistical-work-areas\/diagnostics-waiting-times-and-activity. Operational Insights, NHS England, London 2024."}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-024-08202-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-024-08202-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-024-08202-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:42:26Z","timestamp":1738647746000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-024-08202-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["8202"],"URL":"https:\/\/doi.org\/10.1186\/s12891-024-08202-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4739580\/v1","asserted-by":"object"}]},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"assertion":[{"value":"14 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"BL and AR from IBEX Innovations hold the intellectual property rights over the IBEX BH technology and have a vested interest in the adoption of this technology into clinical practice. ES is employed by Macanda which was funded by IBEX Innovations to conduct this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"112"}}