Nature Medicine asked 11 leading researchers to name their top clinical trial for 2024, and the selected 11 clinical trials covered cutting-edge research areas, including base editing for cholesterol disorders, AI tools for lung cancer detection and emergency room triage, vaccines for HIV and malaria, stem cell therapy for Parkinson’s disease, and immunotherapy for melanoma, reshaping treatment standards and patient outcomes across multiple medical specialties in the coming year. One of the 11 researchers, David Baldwin, a respiratory physician at Nottingham University Hospitals, is leading an ongoing randomized controlled trial involving 150,000 patients across six UK hospitals to test whether artificial intelligence applied to chest X-rays can shorten the time to CT scans and diagnosis. Any significant improvement in time to diagnosis will probably lead to an immediate change in the standard of care to include AI at the time of chest X-ray.
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Expected Impact & Rationale: Nearly three-quarters of lung cancers are diagnosed late at stage 3 or 4, but earlier diagnosis at any stage enables better and more effective treatment. A chest X-ray is most often the first test to suggest lung cancer and, if followed promptly by a computed tomography (CT) scan, can bring the diagnosis forward.
Clinical Trial Overview:
Target Population: The study involves 150,000 patients across six hospitals in the United Kingdom and the trial analyzes patients referred from primary care for a chest X-ray.
Hypothesis: Previous research showed that immediate reporting by radiographers could reduce diagnosis time from 63 days to 32 days; the team hypothesises that AI could further reduce diagnosis time by up to 50%.
The Technology: It utilizes qXR, a Class IIa CE-certified algorithm designed to analyze chest X-rays for chest abnormalities immediately after they’re taken, flagging potential lung cancer cases for faster follow-up with CT scans. Previous research showed that immediate reporting of chest X-rays by radiographers reduced diagnosis time from 63 days to 32 days.
Significance: Baldwin notes that AI is often implemented in hospitals without adequate analysis of clinical impacts. This trial seeks to provide necessary prospective validation and highlight AI’s role in potentially saving lives through earlier lung cancer detection.
