A feature-efficient dual-task machine learning framework for predicting bone mineral density and osteoporosis stratification in resource-constrained environments

Abstract

Osteoporosis is a chronic skeletal disorder characterized by progressive bone mineral density (BMD) loss and structural deterioration, significantly increasing fracture risk. Despite its high prevalence, early detection remains challenging due to its asymptomatic progression and the limitations of conventional diagnostic techniques, such as Dual-Energy X-ray Absorptiometry (DXA). While DXA remains the clinical benchmark for BMD assessment, its high cost, limited accessibility, and inability to directly detect vertebral fractures necessitate the development of alternative, cost-effective, and widely deployable diagnostic methodologies. A dataset of 159 patient records was collected from NORI and CDA Hospital, incorporating 17 input features spanning demographics, genetic/blood type, clinical history and lab tests parameters. To bridge this gap, we developed a practical machine learning model tailored for clinics with limited resources. Instead of relying on expensive imaging, our framework uses only basic, highly accessible clinical markers—specifically ABO blood groups, serum calcium, and potassium levels. Because these tests are inexpensive and easily processed in standard laboratories, our approach removes the financial and technical hurdles of advanced diagnostics, making early screening possible in remote or underfunded healthcare settings. Data preprocessing involved rigorous feature selection, standardization, hyper-parameters tuning, clinically relevant features derivation and biomarker combinations. For classification, ensemble voting classifier was trained on key biomarkers— Weight, Potassium, Calcium and Total Vitamin D—achieving an accuracy of 90% and an AU-ROC score of 0.93 in predicting osteoporosis severity. In parallel, extreme gradient boosting Regressor trained on Age, Weight, ABO Group and Total Vitamin D demonstrated an R 2 of 0.536 for lumbar spine BMD estimation. The proposed framework demonstrates the viability of leveraging machine learning for non-invasive osteoporosis screening and fracture risk assessment, offering a radiation-free and clinically accessible complementary pre-screening tool.