Cost-consequence analysis of artificial intelligence-assisted image reading in lung cancer screening
Author Block: H. L. Lancaster1, K. Togka1, X. Pan1, M. Silva2, D. Han1, M. Oudkerk1; 1Groningen/NL, 2Parma/IT
Purpose: This modelling study aimed to estimate clinical and costs-consequences of a hypothetical AI-assisted image reading solution in LCS in the Netherlands, compared to image reading without AI. Lung cancer screening (LCS) with LDCT detects lung cancer earlier and leads to a reduction in lung cancer mortality by 20-24% (as shown in the NLST and NELSON RCTs). However, implementing LCS may exacerbate the workload of radiologists. Artificial intelligence(AI) exhibits promising outcomes in the detection, segmentation, and classification of lung nodules for LCS. Despite encouraging findings, AI assisted image reading is rarely used within clinical practice.
Methods or Background: A cost-consequence analysis was conducted, capturing costs and effects of different LCS scenarios at baseline from a healthcare perspective. Essential model inputs included; eligible population, screening population, image reading time by radiologists, average weighted time, image reading time by AI, costs, screening effectiveness without AI, and discrepancies in image reading. Control scenario: LCS without AI-assisted image reading. Two radiologists independently read all CT scans. Scenario A: LCS with AI as a parallel-reader. AI read all CT-scans in parallel with a radiologist and the discrepant results assessed by a consensus radiologist. Scenario B: LCS with AI as a first-reader. AI read all CT-scans first, then a radiologist confirmed positive scans and identified false-positive classifications.
Results or Findings: LCS with AI-assisted image reading has the potential to reduce image reading costs by 37% and 73%, in Scenario A and B respectively (total reading costs [Control: €29,676,879; Scenario A: €18,704,843; Scenario B: €8,146,251]). Additionally, utilising AI as the first reader may reduce the radiologists’ workload.
Conclusion: The incorporation of AI-assisted image reading into LCS yields substantial reductions in costs associated with image reading. Our findings support AI utilisation in LCS to alleviate constraints on healthcare resources.
Limitations: No limitations were identified.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: Performed using published data and expert opinions.