Background: Theintegration of artificial intelligence (AI) into clinical decision support systems (CDSSs) has significantly enhanced diagnostic precision, risk stratification, and treatment planning. AI models remain a barrier to clinical adoption, emphasizing the critical role of explainable AI (XAI). Methods: This systematic meta-analysis synthesizes findings from 62 peer-reviewed studies published between 2018 and 2025, examining the use of XAI methods within CDSSs across various clinical domains, including radiology, oncology, neurology, and critical care. Model-agnostic techniques such as visualization models like Gradient-weighted Class Activation Mapping (Grad-CAM) and attention mechanisms dominated in imaging and sequential data tasks. Results: However, there are still gaps in user-friendly evaluation, methodological transparency, and ethical issues, as seen by the absence of research that evaluated explanation fidelity, clinician trust, or usability in real-world settings. In order to enable responsible AI implementation in healthcare, our analysis emphasizes the necessity of longitudinal clinical validation, participatory system design, and uniform interpretability measures. Conclusions: This review offers a thorough analysis of the state of XAI practices in CDSSs today, identifies methodological and practical issues, and suggests a path forward for AI solutions that are open, moral, and clinically relevant.

Background/Objectives: The global burden of spinal cord injury (SCI) is increasing due to aging populations and persistent regional disparities, highlighting an urgent need for updated epidemiological data. This study quantifies the global, regional, and national burden of SCI from 1990 to 2021 and projects its prevalence to 2050. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we estimated age-, sex-, and location-specific prevalence and years lived with disability (YLDs). Projections were developed using sociodemographic modeling, with analyses including Bayesian meta-regression (DisMod-MR 2.1) and Das Gupta decomposition. Results: In 2021, approximately 14.5 million people worldwide were living with SCI, including 7.30 million with neck-level and 7.22 million with below-neck-level injuries. The age-standardized prevalence per 100,000 people was 88 for neck-level SCI and 95 for below-neck-level SCI. Although age-standardized rates declined slightly from 1990 (−0.17% for neck-level and −0.18% for below-neck-level), the absolute burden increased substantially. This increase was particularly prominent in East Asia and low- and middle-income countries. The highest prevalence was observed in men aged 50–64 years. Projections indicate that global SCI cases will exceed 14.5 million by 2050. Conclusions: These findings underscore the growing absolute burden of SCI. Targeted prevention strategies, enhanced rehabilitation services, and equitable healthcare access are crucial to mitigate long-term disability and improve the quality of life for affected populations worldwide.

Background/Objectives: Vertebral fractures (VFs) are a global health issue caused by traumatic or pathological factors that compromise spinal integrity. The burden of VFs is increasing, particularly in older adults. Methods: Data from the Global Burden of Disease 2021 were analyzed to estimate the prevalence, mortality, and years lived with disability due to VFs from 1990 to 2021. Estimates were stratified according to age, sex, and region. Bayesian meta-regression models were used to generate age-standardized rates, and projections for 2050 were calculated using demographic trends and the sociodemographic index. Das Gupta’s decomposition assessed the relative contributions of population growth, aging, and prevalence changes to future case numbers. Results: In 2021, approximately 5.37 million people (95% Uncertainty Interval [UI]: 4.70–6.20 million) experienced VFs globally, with an age-standardized prevalence of 65 per 100,000. Although the rates have declined slightly since 1990, the absolute burden has increased owing to population aging. VF prevalence was the highest in Eastern and Western Europe and in high-income regions. Males had higher VF rates until 70 years of age, after which females surpassed them, reflecting postmenopausal osteoporosis. Falls and road injuries were the leading causes of VF. By 2050, the number of VF cases is expected to increase to 8.01 million (95% UI: 6.57–8.64 million). Conclusions: While the age-standardized VF rates have decreased slightly, the global burden continues to increase. Targeted strategies for the early diagnosis, osteoporosis management, and fall prevention are necessary to reduce the impact of VFs.

Background/Objectives: Vertebral fractures (VFs) are a global health issue caused by traumatic or pathological factors that compromise spinal integrity. With an aging population, the burden of VFs is increasing, particularly in older adults. Methods: Data from the Global Burden of Disease 2021 were analyzed to estimate the prevalence, mortality, and years lived with disability due to traumatic vertebral fractures from 1990 to 2021. Estimates were stratified according to age, sex, and region. Bayesian meta-regression models were used to generate age-standardized rates, and projections to 2050 were calculated using demographic trends and the socio-demographic index. Das Gupta’s decomposition assessed the relative contributions of population growth, aging, and prevalence changes to future case numbers. Results: In 2021, approximately 5.37 million people (95% UI: 4.70–6.20 million) experienced VFs globally, with an age-standardized prevalence of 65 per 100,000. Although rates have declined slightly since 1990, the absolute burden has increased owing to population aging. VF prevalence was the highest in Eastern and Western Europe and high-income regions. Males had higher VF rates until 70 years, after which female rates surpassed them, reflecting postmenopausal osteoporosis. Falls and road injuries were the leading causes of VF. By 2050, VF cases are projected to rise to 8.01 million (95% UI: 6.57–8.64 million). Conclusions: Although age-standardized VF rates have decreased slightly, the global burden continues to increase. Targeted strategies for early diagnosis, management of osteoporosis, and fall prevention are required to reduce the impact of VFs.