Automated detection and classification of the proximal humerus fracture by using deep learning algorithm.

Background and purpose — We aimed to evaluate the ability of artificial intelligence (a deep learning algorithm) to detect and classify proximal humerus fractures using plain anteroposterior shoulder radiographs. Patients and methods — 1,891 images (1 image per person) of normal shoulders (n = 515)...

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Publicado en:Acta Orthopaedica Vol. 89; no. 4; pp. 468 - 474
Autores principales: Chung, Seok Won, Han, Seung Seog, Lee, Ji Whan, Oh, Kyung-Soo, Kim, Na Ra, Yoon, Jong Pil, Kim, Joon Yub, Moon, Sung Hoon, Kwon, Jieun, Lee, Hyo-Jin, Noh, Young-Min, Kim, Youngjun
Formato: diagnostic images research tables/charts Journal Article
Publicado: Medical Journals Sweden AB Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Medical Journals Sweden AB
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        10.1080/17453674.2018.1453714
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        atl: Automated detection and classification of the proximal humerus fracture by using deep learning algorithm.
      aug:
        au:
          Chung, Seok Won
          Han, Seung Seog
          Lee, Ji Whan
          Oh, Kyung-Soo
          Kim, Na Ra
          Yoon, Jong Pil
          Kim, Joon Yub
          Moon, Sung Hoon
          Kwon, Jieun
          Lee, Hyo-Jin
          Noh, Young-Min
          Kim, Youngjun
        affil: Department of Orthopaedic Surgery
      sug:
        subj:
          Humeral Fractures Radiography
          Humeral Fractures Classification
          Artificial Intelligence
          Algorithms
          Automation
          Neural Networks (Computer)
          Sensitivity and Specificity
          Human
          Surgeons
          Shoulder Radiography
          ROC Curve
          Validity
          Youden's J Statistic
          Physicians, Family
          Orthopedic Surgery
      ab: Background and purpose — We aimed to evaluate the ability of artificial intelligence (a deep learning algorithm) to detect and classify proximal humerus fractures using plain anteroposterior shoulder radiographs. Patients and methods — 1,891 images (1 image per person) of normal shoulders (n = 515) and 4 proximal humerus fracture types (greater tuberosity, 346; surgical neck, 514; 3-part, 269; 4-part, 247) classified by 3 specialists were evaluated. We trained a deep convolutional neural network (CNN) after augmentation of a training dataset. The ability of the CNN, as measured by top-1 accuracy, area under receiver operating characteristics curve (AUC), sensitivity/specificity, and Youden index, in comparison with humans (28 general physicians, 11 general orthopedists, and 19 orthopedists specialized in the shoulder) to detect and classify proximal humerus fractures was evaluated. Results — The CNN showed a high performance of 96% top-1 accuracy, 1.00 AUC, 0.99/0.97 sensitivity/specificity, and 0.97 Youden index for distinguishing normal shoulders from proximal humerus fractures. In addition, the CNN showed promising results with 65-86% top-1 accuracy, 0.90-0.98 AUC, 0.88/0.83-0.97/0.94 sensitivity/specificity, and 0.71-0.90 Youden index for classifying fracture type. When compared with the human groups, the CNN showed superior performance to that of general physicians and orthopedists, similar performance to orthopedists specialized in the shoulder, and the superior performance of the CNN was more marked in complex 3- and 4-part fractures. Interpretation — The use of artificial intelligence can accurately detect and classify proximal humerus fractures on plain shoulder AP radiographs. Further studies are necessary to determine the feasibility of applying artificial intelligence in the clinic and whether its use could improve care and outcomes compared with current orthopedic assessments.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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