Evidence map›Paper›PMID 41610279›Full record

Observational studyJMIR medical informatics2026

Prospective Diagnostic Accuracy and Technical Feasibility of Artificial Intelligence-Assisted Rib Fracture Detection on Chest Radiographs: Observational Study.

Shu-Tien Huang, Liong-Rung Liu, Ming-Feng Tsai, Ming-Yuan Huang, Hung-Wen Chiu

Abstract readObservational Study
In one paragraph

Observational study in JMIR medical informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shu-Tien HuangDepartment of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.ORCID 0000-0003-4087-678X
Liong-Rung LiuDepartment of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.ORCID 0000-0003-4891-6299
Ming-Feng TsaiGraduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 9F, Education & Research Building, Shuang-Ho Campus, No. 301, Yuantong Rd., Zhonghe Dist., New Taipei City, 235603, Taiwan, 886 266202589 ext 10929.ORCID 0000-0002-6185-6270
Ming-Yuan Huang *Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.ORCID 0000-0002-1501-9893
Hung-Wen Chiu *Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 9F, Education & Research Building, Shuang-Ho Campus, No. 301, Yuantong Rd., Zhonghe Dist., New Taipei City, 235603, Taiwan, 886 266202589 ext 10929.ORCID 0000-0001-6919-8199

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Rib fractures are present in 10%-15% of thoracic trauma cases but are often missed on chest radiographs, delaying diagnosis and treatment. Artificial intelligence (AI) may improve detection and triage in emergency settings. Objective: This study aims to evaluate diagnostic accuracy, processing speed, and technical feasibility of an artificial intelligence-assisted rib fracture detection system using prospectively collected data within a real-world, high-volume emergency department workflow. Methods: We conducted an observational feasibility study with prospective data collection of a faster region-based convolutional neural network-based AI model deployed in the emergency department to analyze 23,251 real-world chest radiographs (22,946 anteroposterior; 305 oblique) from April 1 to July 2, 2023. This study was approved by the Institutional Review Board of MacKay Memorial Hospital (IRB No. 20MMHIS483e). AI operated passively, without influencing clinical decision-making. The reference standard was the final report issued by board-certified radiologists. A subset of discordant cases underwent post hoc computed tomography review for exploratory analysis. Results: AI achieved 74.5% sensitivity (95% CI 0.708-0.780), 93.3% specificity (95% CI 0.930-0.937), 24.2% positive predictive value, and 99.2% negative predictive value. Median inference time was 10.6 seconds versus 3.3 hours for radiologist reports (paired Wilcoxon signed-rank test W=112 987.5, P<.001). The analysis revealed peak imaging demand between 08:00 and 16:00 and Thursday-Saturday evenings. A 14-day graphics processing unit outage underscored the importance of infrastructure resilience. Conclusions: The AI system demonstrated strong technical feasibility for real-time rib fracture detection in a high-volume emergency department setting, with rapid inference and stable performance during prospective deployment. Although the system showed high negative predictive value, the observed false-positive and false-negative rates indicate that it should be considered a supportive screening tool rather than a stand-alone diagnostic solution or a replacement for clinical judgment. These findings support further clinician-in-the-loop studies to evaluate clinical feasibility, workflow integration, and impact on diagnostic decision-making. However, interpretation is limited by reliance on radiology reports as the reference standard and the system's passive, non-interventional deployment.

Indexed as

Artificial IntelligenceRadiography, ThoracicRib FracturesAdultAgedEmergency Service, HospitalFeasibility StudiesFemaleHumansMaleMiddle AgedProspective StudiesSensitivity and Specificityartificial intelligencechest radiographclinical decision supportdigital healthemergency radiologyfaster R-CNNfeasibility studyreal-world datarib fracture

Identifiers

PMID41610279
PMCPMC12854400

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.