AI could interpret spirometry tests says NICE

New NICE draft guidance has recommended the implementation of a digital tool using artificial intelligence (AI) to interpret spirometry tests at GP practices, which could increase access to testing and reduce waiting times.

It also recommended eight digital platforms providing support for asthma patients, pointing to early evidence that they improve asthma control scores, reduce hospital visits and help use medication ‘more effectively’.

The draft guidance, published on Wednesday, included recommendations on digital technologies that use algorithms to support the diagnosis of asthma and COPD through spirometry testing.

NICE said that the tools ‘use artificial intelligence or step-by-step rules’ to check the quality of spirometry tests, interpret the results and help guide diagnosis decisions and that they could allow ‘less experienced staff’ to perform and interpret spirometry tests, potentially increasing access to testing and reducing waiting times.

It recommended that one technology – ArtiQ.Spiro – can be used in the NHS during an ‘evidence generation period’ in GP surgeries and community diagnostic centres, while four others – EasyOne Connect, GoSpiro, LungHealth and MIR Spiro – ‘need more research’ before they can be recommended for NHS use.

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It said that implementing the technology could lead to staff ‘with different levels of experience’ doing diagnostic spirometry and interpreting results, but that it is currently ‘unknown’ whether this could affect variation in the quality of spirometry and accuracy of interpretation, and subsequent diagnosis.

The guidance said: ‘ArtiQ.Spiro can be used as an option in the NHS during the evidence generation period (three years) and paid for using core NHS funding. During this time, more evidence will be collected to address any uncertainties.’

In separate draft guidance published on the same day, NICE recommended eight digital platforms for asthma patients, which can be used in the NHS while further evidence is collected over the next three years.

The platforms provide people with asthma the option to use apps or online tools ‘to receive access to personalised support’ and should work alongside regular healthcare appointments, not as replacements, NICE said.

These help patients manage their asthma ‘more confidently’ by keeping action plans accessible rather than relying on paper versions that can be lost, and some platforms can share information with GPs or nurses to make appointments ‘more efficient’.

The technologies (see box) can be used during a three-year evidence generation period, after which NICE will review the additional data collected and decide whether to recommend them for routine use across the NHS.

NICE HealthTech programme director Dr Anastasia Chalkidou said: ‘Our independent committee has rigorously assessed the evidence for these digital technologies and concluded they show real promise in helping people better manage their asthma.

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‘By recommending earlier access to these innovations while further evidence is gathered, we’re driving transformational care into the hands of patients and healthcare professionals faster – while ensuring value for the NHS.’

Dr Andy Whittamore, a GP and clinical lead at Asthma+Lung UK, said that assisting with the quality control and interpretation of spirometry results is ‘a good step forwards’ though there are other barriers which need addressing so that more people can get timely, accurate respiratory diagnoses.

He said: ‘As the NHS moves towards greater use of digital technologies to prevent ill health, GPs will play an important role in helping implement the shift of care from hospital to the community.

‘Technologies can help with assisting on quality control and interpretation of spirometry results but there are other accessibility barriers which need addressing so that more people can get access to timely and accurate diagnostic tests.

‘New technologies should allow GPs to better support people with respiratory conditions but are not a replacement for recommended basic care.’

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Both sets of draft guidance are open for consultation until 21 January and NICE welcomes comments from healthcare professionals, patients and the public before final recommendations are made.

Last year, research found that over half of ICSs did not have enough spirometry testing capacity to meet demand.

A version of this story first appeared on our sister title Pulse.