ESR Essentials: how to get to valuable radiology AI: the role of early health technology assessment-practice recommendations by the European Society of Medical Imaging Informatics.

Journal: European radiology
Published Date:

Abstract

AI tools in radiology are revolutionising the diagnosis, evaluation, and management of patients. However, there is a major gap between the large number of developed AI tools and those translated into daily clinical practice, which can be primarily attributed to limited usefulness and trust in current AI tools. Instead of technically driven development, little effort has been put into value-based development to ensure AI tools will have a clinically relevant impact on patient care. An iterative comprehensive value evaluation process covering the complete AI tool lifecycle should be part of radiology AI development. For value assessment of health technologies, health technology assessment (HTA) is an extensively used and comprehensive method. While most aspects of value covered by HTA apply to radiology AI, additional aspects, including transparency, explainability, and robustness, are unique to radiology AI and crucial in its value assessment. Additionally, value assessment should already be included early in the design stage to determine the potential impact and subsequent requirements of the AI tool. Such early assessment should be systematic, transparent, and practical to ensure all stakeholders and value aspects are considered. Hence, early value-based development by incorporating early HTA will lead to more valuable AI tools and thus facilitate translation to clinical practice. CLINICAL RELEVANCE STATEMENT: This paper advocates for the use of early value-based assessments. These assessments promote a comprehensive evaluation on how an AI tool in development can provide value in clinical practice and thus help improve the quality of these tools and the clinical process they support. KEY POINTS: Value in radiology AI should be perceived as a comprehensive term including health technology assessment domains and AI-specific domains. Incorporation of an early health technology assessment for radiology AI during development will lead to more valuable radiology AI tools. Comprehensive and transparent value assessment of radiology AI tools is essential for their widespread adoption.

Authors

  • Erik H M Kemper
    Department of Radiology and Nuclear Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Hendrik Erenstein
    Department of Medical Imaging and Radiation Therapy, The Hanze University of Applied Sciences, Groningen, The Netherlands.
  • Bart-Jan Boverhof
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
  • Ken Redekop
    Erasmus School of Health Policy and Management, Erasmus University, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
  • Anna E Andreychenko
    K-SkAI LLC, Petrozavodsk, Russia; ITMO University, St. Petersburg, Russia. Electronic address: aandreychenko@webiomed.ru.
  • Matthias Dietzel
    Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany.
  • Kevin B W Groot Lipman
    Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
  • Merel Huisman
    Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. merel.huisman1@gmail.com.
  • Michail E Klontzas
    Department of Medical Imaging, Heraklion University Hospital, Crete, 70110, Greece; Advanced Hybrid Imaging Systems, Institute of Computer Science, Foundation for Research and Technology (FORTH), N. Plastira 100, Vassilika Vouton 70013, Heraklion, Crete, Greece. Electronic address: miklontzas@ics.forth.gr.
  • Frans Vos
    Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.
  • Maarten IJzerman
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
  • Martijn P A Starmans
    Biomedical Imaging Group Rotterdam, Departments of Radiology and Nuclear Medicine Medical Informatics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, the Netherlands.
  • Jacob J Visser
    Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.