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Evaluation of the use of artificial intelligence in the detection of appendicular skeletal fractures in adult patients consulting in an emergency department

Evelyne Dubreucq Guerif, Sophie Agut, Alexandra Rousseau, Rudy Bompard and Hélène Goulet

European Journal of Emergency Medicine
,
March 26, 2025

Data

  • Consecutive data of limb x-rays from the emergency department over 1 year
  • 4475 patients in total

Design

  • Retrospective study
  • Only examining radiographs with discrepancies between the AI results and the ED physician’s diagnosis
  • Emergency physicians re-evaluated the discrepant radiographs with AI assistance

Ground truth:

  • Concordance between AI and report
  • In the event of discrepancies, adjudication by a radiologist

Results

  • 603 discordant cases
  • 282 = confirmed fractures
  • 220 were not identified by the emergency physician and 62 were correctly identified

Proportion of fractures missed by the ED physician without AI VS Proportion of fractures missed by the ED physician with AI

78.0% VS 45.3%

  • Diagnostic error rate decreased by 41.9% with AI assistance
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