Consensus statement on the application of artificial intelligence in osteoporosis screening and management: perspectives from the Asia-Pacific region.
Authors
Affiliations (72)
Affiliations (72)
- Department of Family Medicine, Chi Mei Medical Center, Tainan, Taiwan.
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan.
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
- Orthopedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Orthopedics, Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Orthopedics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Superintendent Office, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
- Department of Orthopaedics, National Taiwan University Hospital, Taipei, Taiwan.
- Superintendent Office, Far Eastern Polyclinic of Far Eastern Medical Foundation, Taipei, Taiwan.
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.
- Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
- Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
- School of Medicine for International Students, College of Medicine, I-Shou University School, Kaohsiung, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, BeiHu Branch, Taipei, Taiwan.
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, Singapore, Singapore.
- DUKE NUS Medical School, Singapore, Singapore.
- Family Medicine Service, KK Women's and Children's Hospital, Singapore, Singapore.
- Department of Orthopedics, Beacon Hospital, Petaling Jaya, Malaysia.
- Department of Medicine, Division of Rheumatology, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
- Institute On Aging, Ajou University Medical Center, Suwon, Republic of Korea.
- Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea.
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
- Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand.
- Department of Orthopedics and Trauma Surgery, National Trauma Centre, National Academy of Medical Sciences, Kathmandu, Nepal.
- Service of Bone Diseases, Department of Medicine, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
- Department of Orthopedics, National Taiwan University HsinChu Hospital, Hsin-Chu, Taiwan.
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Shiojiri City, Japan.
- Department of Medicine, University of Ruhuna, Matara, Sri Lanka.
- Centre for Health Technologies, University of Technology Sydney, Ultimo, Australia.
- Tam Anh Research Institute, Ho Chi Minh City, Vietnam.
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA.
- University of Alabama at Birmingham, Birmingham, AL, USA.
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Endocrinology, Quironsalud University Hospital, Madrid, Spain.
- Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
- Department of Obstetrics & Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
- Department of Medicine, University of Santo Tomas Hospital, España, Manila, Philippines.
- Department of Medicine, University of Galway, Galway, Ireland.
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pok Fu Lam, Hong Kong.
- Real-World Study and Application Centre, GBAICTI, Hetao, Hong Kong.
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
- Department of Rehabilitation Medicine, Mahidol University, Nakhon Pathom, Thailand.
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Medicine, Division of Endocrinology, University of Malaya, Kuala Lumpur, Malaysia.
- BioMedicine Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam.
- Department of Medicine, Division of Endocrinology, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
- National Center for Orthopedics, Department of Orthopedics, Shanghai 6, People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.
- Division of Clinical Medicine, School of Medicine & Population Health, University of Sheffield, Sheffield, UK.
- Department of Orthopaedics, The University of Tokyo Hospital, Tokyo, Japan.
- Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland.
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan.
- Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan.
- Graduate Institute of Materials Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan.
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan. [email protected].
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. [email protected].
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan. [email protected].
Abstract
Osteoporosis is a major and growing health concern in the Asia-Pacific region, y et it remains widely underdiagnosed and undertreated due to limited access to dual-energy X-ray absorptiometry (DXA) in many areas. Artificial intelligence (AI) offers new opportunities to improve osteoporosis screening and management, but unvalidated tools pose risks of inconsistent care. This consensus was developed to provide regionally harmonized guidance on the safe, effective, and equitable use of AI in osteoporosis care. The aim of this work was to establish expert consensus recommendations on the role of AI in osteoporosis screening and management in the Asia-Pacific region. Key objectives were to define appropriate applications of AI (e.g., imaging-based bone assessment and fracture risk prediction) and specify minimum standards for validation and reporting, addressing region-specific implementation challenges and ensuring that AI use aligns with clinical guidelines and ethical principles. This consensus was developed through multidisciplinary collaboration among experts across the Asia-Pacific region. Each participant reviewed draft statements, contributed feedback during virtual meetings, and provided insights based on clinical experience and current evidence. Consensus was reached iteratively until full agreement was achieved for all statements. The process integrated global best practices and regional adaptations, drawing from peer-reviewed studies, international AI guidelines, and local fracture registry data. The final recommendations emphasize the validation, transparency, and ethical implementation of AI within regional healthcare systems, ensuring compatibility with local regulations. Ultimately, twelve consensus statements were established to guide the responsible use of AI for osteoporosis screening and management in the Asia-Pacific region. The panel produced 12 consensus statements covering the role of AI as an adjunct for opportunistic osteoporosis screening rather than a diagnostic tool, requirements for imaging quality and AI model transparency, standards for validation and performance reporting, integration of AI with clinical risk stratification, demonstration of clinical utility in real-world settings, adherence to data protection laws and ethical AI principles, training of clinicians in AI use, strategies for implementation and monitoring (including post-market surveillance and feedback loops), and recognition of technical, clinical, and equity limitations of AI. All 12 statements give extensive recommendations for using AI to improve osteoporosis management while ensuring patient safety, accuracy, and equity. This first Asia-Pacific consensus on AI in osteoporosis concludes that AI, when appropriately validated and implemented, can help bridge the osteoporosis care gap by identifying high-risk patients who would otherwise remain undiagnosed, thus facilitating earlier intervention. It emphasizes that AI should complement-not replace-standard diagnostic methods and clinical judgment. The guidance emphasizes validation, transparency, and ethical oversight to facilitate early intervention while minimizing risks associated with unvalidated or premature AI adoption.