Abstract
Secondary fracture prevention programs mostly identify patients with symptomatic non-vertebral fractures, whereas asymptomatic vertebral fractures are usually missed. We here describe the development and validation of a simple method to systematically identify patients with radiographic vertebral fractures using simple text-based searching of free-text radiology reports. The study consisted of two phases. In the development phase (DP), twelve search terms were used to identify vertebral fractures in all X-ray and CT reports issued over a period of 6 months. Positive reports were manually reviewed to confirm whether or not a vertebral fracture had in fact been reported. The three search terms most effective in detecting vertebral fractures during the DP were then applied during the implementation phase (IP) over several weeks to test their ability to identify patients with vertebral fractures. The search terms ‘Loss of Height’ (LoH), ‘Compression Fracture’ (CoF) and ‘Crush Fracture’ (CrF) identified the highest number of imaging reports with a confirmed vertebral fracture. These three search terms identified 581 of 689 (84%) of all true vertebral fractures with a positive predictive value of 76%. Using these three terms in the IP, 126 reports were identified of which 100 (79%) had a vertebral fracture confirmed on manual review. Amongst a sample of 587 reports in week 1 of the IP, 7 (1.2%) were false negatives. Many patients with vertebral fractures can be identified via a simple text-based search of electronic radiology reports. This method may be utilised by secondary fracture prevention programs to narrow the ‘care gap’ in osteoporosis management.
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This project was funded by an unrestricted research grant from the Hospital Contribution Fund (HCF) Research Foundation to JP and KG.
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Jay Pandya, Kirtan Ganda, Lloyd Ridley and Markus J. Seibel declare that they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. The need for informed consent was waived for all patients in the study by the ethics committee.
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Pandya, J., Ganda, K., Ridley, L. et al. Identification of Patients with Osteoporotic Vertebral Fractures via Simple Text Search of Routine Radiology Reports. Calcif Tissue Int 105, 156–160 (2019). https://doi.org/10.1007/s00223-019-00557-6
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DOI: https://doi.org/10.1007/s00223-019-00557-6