Need for Speed: AI, AstraZeneca, and early lung cancer diagnosis

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The AstraZeneca-Qure partnership

A thousand miles begins with a single step. In 2020, Qure.ai and AstraZeneca took the first step together to integrate advanced artificial intelligence (AI) solutions to identify lung diseases early in patients across AstraZeneca’s Emerging Markets region – Latin America, Asia, Africa, and the Middle East. In the past 2 years, the partnership has made significant progress, incorporating the use of AI technology with chest X-rays for multi-disease screening, including tuberculosis and heart failure along with lung cancer.

Lung Cancer: The need for early detection

In more than 40% of people suffering from Lung Cancer, it is detected at Stage 4, when their likelihood of surviving 5 years is under 10%. Only 20% are diagnosed at Stage 1 when the survival rate is between 68-92%. That’s why Lung Cancer is responsible for every 1 in 5 cancer deaths worldwide.

Though early detection facilitates early diagnosis and better patient outcomes, the disease’s silent progress to advanced stages makes it a challenge like none other. Low Dose CT (LDCT) remains the most effective means of screening for Lung Cancer. However, in LMICs, CTs can be prohibitively expensive, priced between USD 500 – 700, limiting their access. However, there is some hope.

Chest X-rays are one the most routinely performed exams in the world, representing 40% of the approximately 3.6 billion imaging tests that are performed annually. As a non-invasive diagnostic test with easy access and low costs, the chest X-ray is a valuable first line test to screen for radiological indications of issues in the lungs, heart, ribs, and more. Acquiring chest X-ray scans only takes minutes; but it warrants expert radiologists to read and analyze them.

Augmenting X-rays with the power AI

qXR, Qure.ai's AI-powered chest X-ray interpretation tool, can automatically detect and localize up to 30 abnormalities, including indicators of Lung Cancer, TB, and COVID-19. This is particularly impactful when millions of scans are examined using qXR to report any abnormalities that could otherwise be missed due to:

  • Lack of experienced personnel
  • Increased workloads, limiting access and time for detailed reads of abnormal scans
  • Incidental nodules indicative for Lung Cancer being missed because physicians are only looking at the results for which the X-rays were ordered and not incidental findings.

How Qure is making a difference

1. Working with grassroot level healthcare professionals

A. Leveraging Primary Care GP clinics in Malaysia

Qualitas Medical Group (QMG) is a chain of integrated general practice (GP) clinics, dental clinics, medical imaging centers, and ambulatory care management centers that play an integral role in Malaysia’s health system. Along with Lung Cancer Network Malaysia, QMG uses qXR to triage all chest X-rays taken of local workers, identifying incidental lung nodules that maybe indicative of lung cancer for further testing. qXR has also helped GPs to reduce their dependency on radiologists for second reads and reduced reporting turnaround time for chest X-rays from 2 days to the same day.

“Qure.ai’s state of the art deep learning technology is a potential game changer that will enhance and expedite diagnosis with rapid referral to relevant specialty “, said Dr Anand Sachithanandan, President, Lung Cancer Network Malaysia

B. Empowering Primary Care Physicians in Latin America

Primary care centers are the first medical care touchpoint and are crucial stakeholders for early diagnosis in disease care pathways. In collaboration with Lung Ambition Alliance, Latin America, Qure is empowering primary care physicians in 12 different countries with AI-enabled smart phone-based chest X-ray analysis and lung nodule screening.

In the absence of digital X-rays, physicians only need to click a picture of the X-ray film against a lightbox and upload it on the app to receive instant qXR analysis. Based on the results, they can guide the patient to the next appropriate steps.

2. Collaborating with Cancer Care Foundations

Assam is called India’s Cancer Capital as the state’s average cancer incident rate is double the national average. The high cancer burden, low public awareness, and a lack of specialised health-care infrastructure led the Govt. of Assam to partner with Tata Trusts and build the Assam Cancer Care Foundation (ACCF).

Potential lung cancer suspects are identified via door-to-door screenings as well as via a screening kiosk set up at the Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta where ACCF have built a specialised cancer care unit. Chest X-rays of these individuals will be screened for detection of suspicious lung nodule(s) using qXR. Based on the result, they will either be called back for an LDCT/Biopsy or an oncology consultation.

3. Surveillance of all chest X-rays taken in a tertiary care hospital

The VPS Lakeshore, Kerala is a tertiary care hospital and a centre of excellence in Oncology and other specialities. It is well equipped to take up largescale screening programs and facilitate the required care continuum for high risk, suspected and confirmed disease cases. The hospital has a program in place where a tool surveys all chest X-rays taken to facilitate early detection of Lung Cancer.

Through our partnership with AstraZeneca, we have deployed qXR to scan all chest X-rays performed at the hospital to pick up possibly early cases of Lung Cancer. If any abnormal/nodule indicative cases are picked up by the software, it is instantly flagged to the radiologist/referring physician so that they can guide the patient along the next steps in the patient care pathway.

4. Public screening road shows

The Ministry Of Public Health, Thailand along with the AstraZeneca team initiated the “Don’t Wait. Get Checked” Lung Cancer Campaign in April ’22 at Central World Mall, in partnership with Banphaeo General Hospital, Digital Economy Promotion Agency (DEPA) and the Central Group. On the occasion of World No Tobacco Day, Qure.ai’s qXR was used to screen close to 200 people. The objective of this program was to directly impact Thailand's public health policies revolving around lung cancer.

Way Forward

“Building health systems that are resilient and sustainable will require finding new ways to prevent disease, diagnose patients earlier, and treat them more effectively. The benefits of the technology that Qure.ai offers align well with our corporate values, ultimately supporting our strategic objective to reshape healthcare delivery, close the cancer care gap and better chronic disease management, especially in low-to-middle income countries. We believe that innovative technology has the potential to transform patients’ outcomes, enabling more people to access care in timely, reliable and affordable ways, regardless of where they live”, said Pei-Chieh Fong, Medical VP, AstraZeneca International.

At the Davos World Economic Forum 2022, AstraZeneca pledged to join the WEF EDISON Alliance and committed to screening 5 million patients for lung cancer by 2025 in partnership with Qure.ai.

With the support of AstraZeneca Turkey, Qure.ai collaborated with Mersin University Hospital on a landmark study for the use of AI in Heart Failure detection, using our qXR suite. This study is an important indicator for the future of AI in healthcare and the use of technology to augment the efforts of physicians in the early detection of other diseases.

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