Artificial intelligence (AI) continues to generate huge amounts of interest for its potential role in the NHS. There is particular interest in AI for breast screening, where it could replace a human reader of mammograms.
We all want to ensure that any introduction of AI to breast screening is well planned and carried out in a way that maintains the high quality standards of the NHS Breast Screening Programme.
There is currently no published evidence that AI would be equivalent or better than the current model of 2 independent human mammogram readers. So it's possible that local breast screening services could be approached to be part of a prospective trial or evaluation.
AI for screening
Public Health England (PHE) has developed interim guidance for AI developers.
It's important to say that any change to include AI in an NHS screening programme would be treated as a major modification by the UK National Screening Committee (UK NSC). As such, the evidence for this change would need to be rigorously evaluated as part of its evidence review process and any recommendation to modify the programme would be subject to public consultation.
AI research encouraged
For now, AI should only be used in a research context until we know it works. The NHS Accelerated Access Collaborative (AAC) will be funding a large study in 2021.
If there are any breast screening services planning to use AI as part of a research project, this would be outside of the standard screening programme as described by the section 7a service specifications. As such you should:
- discuss and seek approval for any change in your programme delivery with your regional NHSEI public health commissioning team
- contact your regional PHE screening quality assurance service (SQAS) team, who can advise both services and commissioners
- ensure projects are approved by the relevant PHE research advisory committee (RAC)
- only share data in line with relevant guidance, especially if you're working with a private company; NHSX has guidance on improving data collaboration (you do not need permission from PHE if the data being shared is from your own service)
Looking to the future
In the future, and following consideration by the UK NSC, PHE (or its successor organisation) will be supporting NHSEI to commission and quality assure AI products within the NHS screening programmes.
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