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Trusts Allocated Money for AI Lung Cancer Diagnosis Tools

A £21 million funding boost promised by the Government in June is now being allocated to 64 NHS trusts in England to deploy artificial intelligence (AI) tools to help clinicians diagnose lung cancer more quickly and accurately. 

England's Health and Social Care Secretary Steve Barclay said: "We are rolling out more cutting-edge AI technology across the NHS to help with quicker, more accurate diagnosis of lung cancer because patients deserve the best care possible." 

NICE Advised Further Evaluation

However, some experts advised exercising caution until the use of AI has undergone further evaluation. 

In an early value assessment published in September, the National Institute for Health and Care Excellence (NICE) said more research was needed on a number of AI-derived software packages for analysing chest X-rays, alongside clinician review, in suspected lung cancer in adults referred from primary care.

The new AI tools, which will help clinicians analyse X-rays and CT scans, will start to be deployed in NHS hospitals in England this winter. The Department of Health and Social Care (DHSC) said it would help to ease pressures on the NHS and free up staff time as well as "increasing efficiency and cutting down waiting times". 

The Government has already invested £123 million in 86 AI technologies, supporting stroke diagnosis, screening, cardiovascular monitoring, and managing various conditions at home. Mr Barclay said that AI was enabling treatment times for stroke patients to be halved, and that by assisting doctors in analysing brain scans it could reduce the time between admission and treatment by more than an hour. "We're building on this success to make sure lung cancer patients get the support they need, when they need it," he said.

Poor Lung Cancer Survival Rate

According to Cancer Research UK, lung cancer incidence approaches 50,000 cases each year, with nearly 35,000 deaths annually, and a 10% 10-year survival rate. The DHSC said that over 600,000 chest X-rays were performed each month in England, and the deployment of AI technology to more NHS trusts would support clinicians and enable quicker, more accurate diagnosis. 

Dr Vin Diwakar, national director of transformation at NHS England, said: "This investment will allow 64 NHS trusts from across the country to harness the power of AI to tools to speed up the diagnosis and treatment of lung cancer."

The DHSC admitted that AI "does not always lend itself to traditional methods of demonstrating evidence for effectiveness". In partnership with the Medicines and Healthcare products Regulatory Agency, regulators, and industry, it had developed a system, known as AI-Airlock, to enable AI technology to be tested in NHS settings safely, "ahead of regulatory approval". 

AI "May Not Improve Clinical Outcomes" 

However, NICE said, "There is no evidence to show how accurate software-assisted clinician review will be at identifying lung abnormalities, compared with clinician review alone, in people referred for a chest X‑ray by their GP." 

"Using this software could lead to lung cancer being missed, or people having unnecessary CT scans, which can cause anxiety," it said. "This could also increase costs and overburden CT services." NICE concluded that AI "may not improve clinical outcomes" in this setting and "should not currently be used to inform clinical care".

Responding to the funding announcement, Sir Julian Hartley, chief executive of NHS Providers, said, "At a time when waiting lists are at another record high and the NHS workforce is under significant pressure, new technologies, such as AI, have the potential to offer major benefits to patients, staff, and healthcare."

However, he said, "The success of these new innovations will depend on sustainable funding for digital teams, who are fundamental to enabling and embedding smarter working across the health service."

Commenting to Medscape News UK, Mick Peake, chair of the UK Lung Cancer Coalition (UKLCC) and honorary professor of respiratory medicine at the University of Leicester, said, "The UKLCC welcomes this initiative, which could help the earlier diagnosis of lung cancer and the better and more efficient assessment of the risk of indeterminate nodules in the lung being cancerous."

"However, we urge an element of caution and the need to assess the accuracy of these new technologies with proper evaluation."

Allocation of the £21 million coincided with an international summit on AI safety which began on Wednesday at Bletchley Park in Buckinghamshire.

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