People who may have broken a bone could have their x-ray examined
using artificial intelligence technologies, NICE has said in
draft guidance.
In addition to a trained healthcare professional reviewing the
x-ray, an independent NICE committee has said one of four AI
tools can be used to help detect fractures on X-rays in urgent
care.
The recommendation allows TechCare Alert, BoneView, RBfracture or
Rayvolve to be used in urgent care settings in England while
further evidence is generated to demonstrate the technology's
benefits in a real-world setting.
Clinical evidence suggests that the AI technologies may improve
fracture detection on X-rays in urgent care, compared with just a
professional reviewing on their own, without increasing the risk
of incorrect diagnoses.
Using AI technologies may help reduce variation in care across
the country, reduce the number of fractures that are missed at
initial presentation, and prevent further injury or harm to
people during the time between the initial assessment and a
decision on further treatment.
The committee heard missed fractures are reported to be the most
common diagnostic error in the emergency department[i]. Missed
or delayed diagnosis of fractures on radiographs is reported to
occur in around 3% to 10% of cases[ii].
, director of HealthTech at
NICE, said: “Every day across the NHS thousands of
images are interpreted by expert radiologists and radiographers,
but there is a high vacancy rate within these departments across
the country and more support is needed to manage their workload.
“These AI technologies are safe to use and could spot fractures
which humans might miss given the pressure and demands these
professional groups work under.
“Using AI technology to help highly skilled professionals in
urgent care centres to identify which of their patients has a
fracture could potentially speed up diagnosis and reduce follow
up appointments needed because of a fracture missed during an
initial assessment.”
The NHS Long Term Plan[iii] noted that in England
“vacancy rates are 12.5% for radiologists and 15% for
radiographers.”
The committee noted that the use of these technologies is
considered low risk as each image is reviewed by a professional
and the AI isn't working in isolation. Therefore, it is unlikely
using the technologies will lead to an increase in unnecessary
referrals to fracture clinics. An independent review carried out
by the radiology department will still take place.
After the consultation, responses will be considered by the
committee who may then alter their recommendations before final
guidance is published on the NICE website.
A consultation on the draft recommendations has begun and
comments can be submitted via the NICE website until Tuesday 5
November 2024.
ENDS
About the guidance
- The draft guidance will be available at https://www.nice.org.uk/guidance/indevelopment/gid-hte10044/documents
from 00.01 on Tuesday 22 October 2024.
- An embargoed copy of the draft guidance is attached
References
[i]
Hussain et al. 2019
[ii]
Kuo et al. 2022
[iii]
http://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
