Collaboration between clinicians and vision-language models in radiology report generation.

Journal: Nature medicine
PMID:

Abstract

Automated radiology report generation has the potential to improve patient care and reduce the workload of radiologists. However, the path toward real-world adoption has been stymied by the challenge of evaluating the clinical quality of artificial intelligence (AI)-generated reports. We build a state-of-the-art report generation system for chest radiographs, called Flamingo-CXR, and perform an expert evaluation of AI-generated reports by engaging a panel of board-certified radiologists. We observe a wide distribution of preferences across the panel and across clinical settings, with 56.1% of Flamingo-CXR intensive care reports evaluated to be preferable or equivalent to clinician reports, by half or more of the panel, rising to 77.7% for in/outpatient X-rays overall and to 94% for the subset of cases with no pertinent abnormal findings. Errors were observed in human-written reports and Flamingo-CXR reports, with 24.8% of in/outpatient cases containing clinically significant errors in both report types, 22.8% in Flamingo-CXR reports only and 14.0% in human reports only. For reports that contain errors we develop an assistive setting, a demonstration of clinician-AI collaboration for radiology report composition, indicating new possibilities for potential clinical utility.

Authors

  • Ryutaro Tanno
    Centre for Medical Image Computing and Department of Computer Science, UCL, Gower Street, London WC1E 6BT, UK; Healthcare Intelligence, Microsoft Research Cambridge, UK. Electronic address: r.tanno@cs.ucl.ac.uk.
  • David G T Barrett
    Google DeepMind, London, UK. barrettdavid@google.com.
  • Andrew Sellergren
    Google Research, London, UK.
  • Sumedh Ghaisas
    Google DeepMind, London, UK.
  • Sumanth Dathathri
    Google DeepMind, London, UK.
  • Abigail See
    Google DeepMind, London, UK.
  • Johannes Welbl
    Google DeepMind, London, UK.
  • Charles Lau
    From Google Health, Google, 3400 Hillview Ave, Palo Alto, CA 94304 (A.B.S., C.C., Z.N., Y. Liu, K.E., D.T., N.B., S.S.); Google Research, Cambridge, Mass (Y. Li, A.M., A.S., J.H., D.K.); Google via Advanced Clinical, Deerfield, Ill (C.L.); Apollo Radiology International, Hyderabad, India (S.R.K.); and Northwestern Medicine, Chicago, Ill (M.E., F.G.V., D.M.).
  • Tao Tu
    Google Research, Mountain View, CA, USA.
  • Shekoofeh Azizi
  • Karan Singhal
    Google Research, Mountain View, CA, USA. karansinghal@google.com.
  • Mike Schaekermann
    Google Health, Google LLC, Mountain View, California.
  • Rhys May
    Google DeepMind, London, UK.
  • Roy Lee
    Google Health, Palo Alto, CA, USA.
  • SiWai Man
    Google Research, London, UK.
  • Sara Mahdavi
    Vancouver Cancer Centre, Vancouver, BC, Canada.
  • Zahra Ahmed
    Google DeepMind, London, UK.
  • Yossi Matias
    Google Research, Google LLC, 1600 Amphitheatre Parkway, Mountain View, CA, USA.
  • Joelle Barral
    Google Research, Mountain View, CA, USA.
  • S M Ali Eslami
    DeepMind, 5 New Street Square, London EC4A 3TW, UK. aeslami@google.com.
  • Danielle Belgrave
    Microsoft Research Cambridge, Cambridge, United Kingdom.
  • Yun Liu
    Google Health, Palo Alto, CA USA.
  • Sreenivasa Raju Kalidindi
    From Google Health, Google, 3400 Hillview Ave, Palo Alto, CA 94304 (A.B.S., C.C., Z.N., Y. Liu, K.E., D.T., N.B., S.S.); Google Research, Cambridge, Mass (Y. Li, A.M., A.S., J.H., D.K.); Google via Advanced Clinical, Deerfield, Ill (C.L.); Apollo Radiology International, Hyderabad, India (S.R.K.); and Northwestern Medicine, Chicago, Ill (M.E., F.G.V., D.M.).
  • Shravya Shetty
    Google AI, Mountain View, CA, USA.
  • Vivek Natarajan
    Google, Mountain View, CA, USA.
  • Pushmeet Kohli
    DeepMind, London, UK.
  • Po-Sen Huang
    Google DeepMind, London, UK.
  • Alan Karthikesalingam
    Department of Outcomes Research, St George's Vascular Institute, London, SW17 0QT, United Kingdom.
  • Ira Ktena
    Google DeepMind, London, UK. iraktena@google.com.