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Skeletal Radiology

Evaluating Milvue SmartUrgences for Hip Fracture Diagnosis on Emergency Department Radiographs

This retrospective diagnostic accuracy study enrolled 539 consecutive patients aged 60 years or older undergoing hip and pelvis radiography at two emergency departments, used a consensus panel of three musculoskeletal radiologists and two senior orthopaedic trauma surgeons blinded to AI output as the reference standard, and evaluated Milvue SmartUrgences, which classified radiographs as "YES," "NO," or "DOUBT"; 487 patients received definitive classifications and entered the primary analysis (mean age 83.4 years, SD 8.4; 66% female; 191 hip fractures identified by the reference standard), yielding sensitivity 97.4% (95% CI 94.0-98.9), specificity 86.5% (95% CI 82.1-89.9), positive predictive value 82.3% (95% CI 76.8-86.7), negative predictive value 98.1% (95% CI 95.6-99.2), accuracy 90.