AI for fracture diagnosis in clinical practice: Four approaches to systematic AI-implementation and their impact on AI-effectiveness

Implementation methods have a large impact on AI-effectiveness. These results suggest AI should not be considered for problem-solving or triage at this time; AI standalone performs better than either and may be a source of assistance where radiologists are unavailable. Best results were obtained implementing AI as safety net, which eliminates missed fractures with serious clinical consequences; even though false positives are increased, unnecessary treatments are limited.