| Status | In progress |
| Technology type | Device |
| Decision | Selected |
| Reason for decision | Anticipate the topic will be of importance to patients, carers, professionals, commissioners and the health of the public to ensure clinical benefit is realised, inequalities in use addressed, and help them make the best use of NHS resources |
| Further information | This topic area has been identified by NICE as a clinical area of importance. Vertebral fragility fractures (VFFs) are fractures in the spine that occur following a fall from standing height or less. VFFs are the most common type of fragility fractures caused by osteoporosis (a result of bone weakness). They may occur spontaneously, with falls or as a result of day to day activities. Osteoporosis is a condition that results in bone weakness. Its incidence increases with age, particularly after menopause in women, but it may also be caused or made worse by hormonal changes, vitamin deficiencies, genetic factors or other conditions such as cancer, metabolic or endocrine disorders. VFFs may be difficult to diagnose clinically. Often, they are detected incidentally on radiographic images, but up to 70% remain undiagnosed. People with a VFF often experience deformity, height loss, immobility and pain, which leads to reduced quality of life. The risk of death is also substantially higher. Furthermore, VFFs are a strong predictor of further osteoporotic fractures, especially of the hip. There are notable age and gender inequalities. The incidence of VFFs in women aged 50-79 is 12%, increasing to 20% in women aged over 80. The economic cost of fractures to the NHS was £5.25 billion in 2017 with a predicted increase to £6.83 billion by 2030. Pharmacological treatments are available which are effective at reducing the risk of further VFFs and subsequent hip fractures substantially. One way to improve VFF detection is to assess radiographic images that include the spine taken for reasons other than a suspected vertebral fracture. This is known as opportunistic detection. Artificial intelligence (AI) technologies have the potential to improve the detection of VFFs. They may be able to detect fractures which would otherwise have been missed, while also reducing the time needed to interpret a radiographic image. The clinical integration of AI technologies has the potential to reduce the burden of osteoporotic fractures by ensuring those who require treatment receive it in a timely manner. NICE’s HealthTech programme will assess the clinical and cost-effectiveness of using AI technologies to help detect VFFs in order to make recommendations on their use in the NHS. |
Provisional Schedule
| SCM Recruitment Closes | 16 January 2025 |
| Scoping workshop | 29 January 2025 |
| Final scope | 20 February 2025 |
| Committee meeting: 1 | 13 May 2025 |
| Draft guidance | 16 June 2025 - 30 June 2025 |
| Resolution | 28 July 2025 |
| Expected publication | 20 August 2025 |
Project Team
| Project lead | Deonee Stanislaus |
Email enquiries
- If you have any queries please email Diagnostics@nice.org.uk
Timeline
Key events during the development of the guidance:
| Date | Update |
|---|---|
| 21 November 2024 | In progress. Launch |
| 21 November 2024 | SCM Recruitment Starts |
| 13 November 2024 | Awaiting development. Status change linked to Topic Selection Decision being set to Selected |