Precision management of gastrointestinal tumor-associated osteoporosis driven by cutting-edge technologies: Current status, challenges, and future prospects

Table 2 Core challenges in the precision management of gastrointestinal tumor-associated osteoporosis

Category	Core challenges
Clinical translation barriers	AI models: Insufficient generalization, overfitting, poor interpretability, lack of multicenter validation. Nanodrugs: Unclear in vivo mechanism, long translation cycle, high cost, difficult quality control, biosafety risks, poor scenario adaptability
Data integration and standardization	Data islands among departments and institutions. Multisource heterogeneous data with poor interoperability. Nonuniform detection standards for bone metabolic markers. Ethical and privacy barriers restricting data sharing
Imperfect MDT cooperation	MDT is passive and delayed rather than proactive. Knowledge barriers between oncology, orthopedics, nutrition, etc. Lack of standardized GTO-specific guidelines and workflows
Ethical and safety risks	Data privacy and security issues in AI applications. “Black box” problem of AI leading to low clinical trust. Unknown long-term biosafety of nanomaterials. Individual heterogeneity and potential toxicity of nanodrugs

GTO: Gastrointestinal tumor-associated osteoporosis; AI: Artificial intelligence; MDT: Multidisciplinary team.