In another blow to radiology AI, the UK’s national technology assessment agency issued an equivocal report on AI for chest X-ray, stating that more research is needed before the technology can enter routine clinical use.
The report came from the National Institute for Health and Care Excellence (NICE), which assesses new health technologies that have the potential to address unmet NHS needs.
The NHS sees AI as a potential solution to its challenge of meeting rising demand for imaging services, a dynamic that’s leading to long wait times for exams.
- The NHS has taken several steps to spur AI adoption, such as the launch of the AI Diagnostic Fund to pay for chest X-ray pilot projects and the piloting of a national platform for AI deployment.
But at least some corners of the UK health establishment have concerns about whether AI for chest X-ray is ready for prime time.
- The NICE report states that – despite the unmet need for quicker chest X-ray reporting – there is insufficient evidence to support the technology, and as such it’s not possible to assess its clinical and cost benefits. And it said there is “no evidence” on the accuracy of AI-assisted clinician review compared to clinicians working alone.
As such, the use of AI for chest X-ray in the NHS should be limited to research, with the following additional recommendations …
- Centers already using AI software to review chest X-rays may continue to do so, but only as part of an evaluation framework and alongside clinician review
- Purchase of chest X-ray AI software should be made through corporate, research, or non-core NHS funding
- More research is needed on AI’s impact on a number of outcomes, such as CT referrals, healthcare costs and resource use, review and reporting time, and diagnostic accuracy when used alongside clinician review
The NICE report listed 14 commercially available chest X-ray algorithms that need more research, and it recommended prospective studies to address gaps in evidence. AI developers will be responsible for performing these studies.
Taken with last week’s disappointing news on AI for radiology, the NICE report is a wakeup call for what had been one of the most promising clinical use cases for AI. The NHS had been seen as a leader in spearheading clinical adoption of AI; for chest X-ray, clinicians in the UK may have to wait just a bit longer.