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Study ObjectivesIn previous research, we built a deep neural network model based on Inception-Resnet-v2 to predict bone age (EFAI-BAA). The primary objective of the study was to determine if the EFAI-BAA was substantially concordant with the qualified physicians in assessing bone ages. The secondary objective of the study was to determine if the EFAI-BAA was no different in the clinical rating (advanced, normal, or delayed) with the qualified physicians.MethodThis was a retrospective study. The left-hand X-ray images of male subjects aged 3–16 years old and female subjects aged 2–15 years old were collected from China Medical University Hospital (CMUH) and Asia University Hospital (AUH) retrospectively since the trial began until the included image amount reached 368. This was a blinded study. The qualified physicians who ran, read, and interpreted the tests were blinded to the values assessed by the other qualified physicians and the EFAI-BAA.ResultsThe concordance correlation coefficient (CCC) between the EFAI-BAA (EFAI-BAA), the evaluation of bone age by physician in Kaohsiung Veterans General Hospital (KVGH), Taichung Veterans General Hospital (TVGH2), and in Taipei Tzu Chi Hospital (TZUCHI-TP) was 0.9828 (95% CI: 0.9790–0.9859, p-value = 0.6782), 0.9739 (95% CI: 0.9681–0.9786, p-value = 0.0202), and 0.9592 (95% CI: 0.9501–0.9666, p-value = 0.4855), respectively.ConclusionThere was a consistency of bone age assessment between the EFAI-BAA and each one of the three qualified physicians (CCC = 0.9). As the significant difference in the clinical rating was only found between the EFAI-BAA and the qualified physician in TVGH2, the performance of the EFAI-BAA was considered similar to the qualified physicians.

Hip fracture is a major public health concern, with high incidence rates in the elderly worldwide. Hip fractures are associated with increased medical costs, patient dependency on families, and higher rates of morbidity and mortality. Chinese herbal medicine (CHM) is typically characterized as cost-effective and suitable for long-term use with few side effects. To better understand the effects of CHM on hip fracture patients, we utilized a population-based database to investigate the demographic characteristics, cumulative incidence of overall mortality, readmission, reoperation, and patterns of CHM prescription. We found that CHM usage was associated with a lower risk of overall mortality [P = 0.0009; adjusted hazard ratio (HR): 0.47, 95% confidence interval (CI): 0.30–0.73], readmission (P = 0.0345; adjusted HR: 0.67, 95% CI: 0.46–0.97), and reoperation (P = 0.0009; adjusted HR: 0.57, 95% CI: 0.40–0.79) after adjustment for age, type of hip fracture, surgical treatment type, and comorbidities. We also identified the herbal formulas, single herbs, and prescription patterns for the treatment of hip fracture by using association rule mining and network analysis. For hip fracture patients, the most common CHM coprescription pattern was Du-Zhong (DZ) → Xu-Duan (XD), followed by Du-Huo-Ji-Sheng-Tang (DHJST) → Shu-Jing-Huo-Xue-Tang (SJHXT), and Gu-Sui-Bu (GSB) → Xu-Duan (XD). Furthermore, XD was the core prescription, and DZ, GSB, SJHXT, and DHJST were important prescriptions located in cluster 1 of the prescription patterns. This study provides evidence for clinical CHM use as an adjunctive therapy that offers benefits to hip fracture patients.