Cost-Effectiveness of Opportunistic Osteoporosis Screening Using Chest Radiographs With Deep Learning in the United States.

Hiligsmann M, Silverman SL, Reginster JY

Journal of the American College of Radiology : JACR6 Aug 2025Cited by 6 (Europe PMC)

PMID40780311DOI10.1016/j.jacr.2025.07.028PepBankPUB-40780311

Publisher page PubMedAsk about this study

Summary

ObjectivesDeep learning models applied to chest radiographs obtained for other clinical reasons have shown promise in opportunistic osteoporosis screening, particularly among middle-aged to older individuals. This study evaluates the cost-effectiveness of this approach in US women aged 50 years and over.MethodsAn economic model, incorporating both a decision tree and a microsimulation Markov model, estimated the cost per quality-adjusted life-year (QALY) gained (in 2024 US dollars) for screening via chest radiographs with deep learning, followed by treatment, versus no screening and treatment. The patient pathways were based on the sensitivity and specificity of artificial intelligence-enhanced radiographs. Real-world medication persistence, realistic assumptions for probabilities of dual-energy x-ray absorptiometry examination postscreening detection and for treatment initiation rates were incorporated. Women with osteoporosis were stratified into high risk (receiving alendronate monotherapy for 5 years) and very high risk (receiving an 18-month anabolic treatment with abaloparatide followed by 5 years of alendronate). Parameter uncertainty was analyzed through sensitivity analyses.ResultsThe opportunistic screening strategy improved health outcomes, yielding more QALYs and fewer fractures while increasing treatment costs. The cost per QALY gained of opportunistic screening was estimated at $72,085 per QALY gained among women 50+, remaining below the US cost-effectiveness threshold of $100,000 per QALY. Further improvements in cost-effectiveness could be achieved by optimizing follow-up, treatment initiation, and medication adherence.DiscussionThis study underscores the cost-effectiveness and public health value of opportunistic, artificial intelligence-driven screening osteoporosis screening using existing chest radiographs, demonstrating its potential to improve early detection and address unmet diagnostic needs in osteoporosis care.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study4

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone4

In this study, Abaloparatide (Tymlos) was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Abaloparatide (Tymlos).

01Computer modelNot a test of Abaloparatide (Tymlos) aloneIn silicoOther
In an economic model, screening followed by risk-based regimens including abaloparatide then alendronate increased QALYs versus no screening and treatment.
In plain wordsIn computer models, screening followed by treatment regimens including abaloparatide then alendronate increased quality-adjusted life-years versus no screening and treatment.
Peptide
Abaloparatide (Tymlos)
Outcome
IncreaseQuality-adjusted life-years
Study
n: not reported in source
decision tree and microsimulation Markov model of US women aged 50 years and over
Comparator
no screening and treatment
Outcome group
Cost-effectiveness · Whole body
Source sentences
Summary
The opportunistic screening strategy improved health outcomes, yielding more QALYs and fewer fractures while increasing treatment costs.
2 context sentences(design, population, supporting numbers)
Summary · context
An economic model, incorporating both a decision tree and a microsimulation Markov model, estimated the cost per quality-adjusted life-year (QALY) gained (in 2024 US dollars) for screening via chest radiographs with deep learning, followed by treatment, versus no screening and treatment.
Summary · context
Women with osteoporosis were stratified into high risk (receiving alendronate monotherapy for 5 years) and very high risk (receiving an 18-month anabolic treatment with abaloparatide followed by 5 years of alendronate).
In this study, Abaloparatide (Tymlos) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Abaloparatide (Tymlos).
Show in the study text Report a problemFND-4078031101
02Computer modelNot a test of Abaloparatide (Tymlos) aloneIn silicoOther
In an economic model, screening followed by risk-based regimens including abaloparatide then alendronate reduced fractures versus no screening and treatment.
In plain wordsIn computer models, screening followed by treatment regimens including abaloparatide then alendronate reduced fractures versus no screening and treatment.
Peptide
Abaloparatide (Tymlos)
Outcome
DecreaseFractures
Study
n: not reported in source
decision tree and microsimulation Markov model of US women aged 50 years and over
Comparator
no screening and treatment
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
The opportunistic screening strategy improved health outcomes, yielding more QALYs and fewer fractures while increasing treatment costs.
2 context sentences(design, population, supporting numbers)
Summary · context
An economic model, incorporating both a decision tree and a microsimulation Markov model, estimated the cost per quality-adjusted life-year (QALY) gained (in 2024 US dollars) for screening via chest radiographs with deep learning, followed by treatment, versus no screening and treatment.
Summary · context
Women with osteoporosis were stratified into high risk (receiving alendronate monotherapy for 5 years) and very high risk (receiving an 18-month anabolic treatment with abaloparatide followed by 5 years of alendronate).
In this study, Abaloparatide (Tymlos) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Abaloparatide (Tymlos).
Show in the study text Report a problemFND-4078031102
03Computer modelNot a test of Abaloparatide (Tymlos) aloneIn silicoOther
In an economic model, screening followed by risk-based regimens including abaloparatide then alendronate increased treatment costs versus no screening and treatment.
In plain wordsIn computer models, screening followed by treatment regimens including abaloparatide then alendronate increased treatment costs versus no screening and treatment.
Peptide
Abaloparatide (Tymlos)
Outcome
IncreaseTreatment costs
Study
n: not reported in source
decision tree and microsimulation Markov model of US women aged 50 years and over
Comparator
no screening and treatment
Outcome group
Cost-effectiveness · Whole body
Source sentences
Summary
The opportunistic screening strategy improved health outcomes, yielding more QALYs and fewer fractures while increasing treatment costs.
2 context sentences(design, population, supporting numbers)
Summary · context
An economic model, incorporating both a decision tree and a microsimulation Markov model, estimated the cost per quality-adjusted life-year (QALY) gained (in 2024 US dollars) for screening via chest radiographs with deep learning, followed by treatment, versus no screening and treatment.
Summary · context
Women with osteoporosis were stratified into high risk (receiving alendronate monotherapy for 5 years) and very high risk (receiving an 18-month anabolic treatment with abaloparatide followed by 5 years of alendronate).
In this study, Abaloparatide (Tymlos) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Abaloparatide (Tymlos).
Show in the study text Report a problemFND-4078031103
04Computer modelNot a test of Abaloparatide (Tymlos) aloneIn silicoOther
In US women aged 50+, modeled screening with risk-based treatment regimens including abaloparatide then alendronate cost $72,085 per QALY gained.
In plain wordsIn computer models, screening with regimens including abaloparatide then alendronate cost $72,085 per quality-adjusted life-year gained versus no screening and treatment.
Peptide
Abaloparatide (Tymlos)
Outcome
Not applicableCost per QALY gained
Study
n: not reported in source
decision tree and microsimulation Markov model of US women aged 50 years and over
Comparator
no screening and treatment
Outcome group
Cost-effectiveness · Whole body
Source sentences
Summary
The cost per QALY gained of opportunistic screening was estimated at $72,085 per QALY gained among women 50+, remaining below the US cost-effectiveness threshold of $100,000 per QALY.
2 context sentences(design, population, supporting numbers)
Summary · context
An economic model, incorporating both a decision tree and a microsimulation Markov model, estimated the cost per quality-adjusted life-year (QALY) gained (in 2024 US dollars) for screening via chest radiographs with deep learning, followed by treatment, versus no screening and treatment.
Summary · context
Women with osteoporosis were stratified into high risk (receiving alendronate monotherapy for 5 years) and very high risk (receiving an 18-month anabolic treatment with abaloparatide followed by 5 years of alendronate).
In this study, Abaloparatide (Tymlos) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Abaloparatide (Tymlos).
Show in the study text Report a problemFND-4078031104

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
22 Oct 2026, 02:25 UTC
Study results updated
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC

Subjects

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