Enhanced multi-class object detector for bone fracture diagnosis with prescription recommendation

Bone fractures are among the most prominent injuries in the modern world that affect all ages and races. Traditional treatment involves radiographic imaging that relies heavily on radiologists manually analyzing images. There have been efforts to develop computer-aided diagnosis tools that employ artificial intelligence and deep learning approaches. Existing literature focuses on developing tools that only detect and classify bone fractures, rather than addressing the broader issue of bone fracture management. However, evidence of scholarly works that include treatment recommendations is still lacking. Furthermore, deep learning-based object detectors that achieve state-of-the-art results are computationally expensive and considered as black-box solutions. Developing countries, such as Sub-Saharan Africa, face a shortage of radiologists and orthopedists. For this reason, this paper proposes a methodological approach that uses a more efficient object detection model to diagnose long bone fractures and provide prescription recommendations. An enhanced anchoring process, known as adaptive anchoring, is proposed to improve the performance of the Regional Proposal Network and the object detection model. A Faster R-CNN model with ResNet-50/101 and ResNext-50/101 backbones was used to develop an object detection model that uses X-ray images as input. To understand and interpret the model's decision, a Gradient-based Class Activation Mapping method was used to assess the model's learnability. The results indicate that the proposed adaptive anchoring approach can improve computational efficiency, reducing training time by up to 29% compared to the traditional approach. Model accuracy during training and validation ranged between 94% and 98%. Overall, adaptive anchoring performed better when applied with the ResNet-101 backbone, yielding an Average Precision of 92.73%, an F1 score of 96.01%, a precision of 96.80%, and a recall of 95.23%. The study provides valuable insights into the use of computationally efficient deep learning models for medical recommendation systems. Future studies should develop models to diagnose fractures using input images from various modalities and to provide prescription recommendations.