DL on thoracolumbar X-rays plus clinical factors predicts incident vertebral fracture

Combining DL features from thoracolumbar X-rays with clinical factors improved 2-year fracture prediction (AUC 0.774) vs clinical model alone, with net reclassification improvement 0.241 in validation.

• The combined model had good calibration (intercept 0.012; slope 0.972).
• Decision curve analysis showed greater net benefit over the clinical model.

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