Advanced Prediction of Recurrent Fragility Fractures Using Large Language Models

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Abstract

Recurrent fragility fractures are a big challenge in managing bone health, especially in older adults and people with osteoporosis or related disorders. The prediction of such fractures depends on the overall understanding of various clinical and lifestyle factors contributing to bone fragility. The goal of this analysis is to carry out advanced predictive analytics related to the problem of recurrent fragility fractures concerning several key features about each patient: age, sex, body mass index, physical activities, smoking status, and several others: T-score, along with biomarkers such as Vitamin D3, calcium levels, and the rest. Indeed, the results show that the features most indicative of recurrent fractures include age, T-score, physical activity, and glucocorticoid usage; greater emphasis has been laid on bone mineral density and lifestyle factors. The detailed feature importance analysis showed that age and T-score have the highest important values for fracture recurrence prediction, followed by physical activity and glucocorticoid treatment. The study finds that the proposed models achieved an accuracy of 91.3% (LLaMA 7GB) and 90.2% (Gamma 7GB), with ROC AUC scores of 93% and 92%, respectively. The study highlights that age, T-score, and glucocorticoid usage were the most significant predictive factors. These findings enable improved clinical decision-making for fracture prevention. This model can facilitate the identification of high-risk patients with recurrent fragility fractures by clinicians, thus allowing for targeted intervention and personalized treatment to reduce the risk of future fractures. The findings contribute to the development of fracture prediction, incorporating a wide array of clinical data that, in turn, will improve patient outcomes and their quality of life.

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Alshraideh, M., Al-Dhaqm, A., Alshammari, A., Alshraideh, A., Alshraideh, B., Mohamed Al-Fayoumi, B., & Nasser, M. (2025). Advanced Prediction of Recurrent Fragility Fractures Using Large Language Models. IEEE Access, 13, 71503–71520. https://doi.org/10.1109/ACCESS.2025.3562259

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