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<p>The impact of incorporating artificial intelligence (AI) into a double-read breast-screening workflow, including arbitration, is unclear. This retrospective study included 50,000 representative women from two NHS breast-screening centers. All the women had long-term follow-up, allowing us to determine whether use of AI leads to earlier cancer detection. Cases requiring arbitration (8,732 cases) were read by 22 readers in a reader study, following their normal arbitration workflow. Overall, after arbitration, replacing the second reader with AI was noninferior (5% margin) to two human readers in terms of sensitivity and specificity (<i>P</i> &lt; 0.001) while offering a workload benefit. Arbitration improved the specificity of the AI arm by overruling cases incorrectly recalled by the AI tool; however, it also overruled the AI tool recall decision for some interval and next-round cancers. Further development of the AI tool alongside improvement in its explainability could lead to the earlier detection of cancers.</p>

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Impact of using artificial intelligence as a second reader in breast screening including arbitration

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月10日

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  • Lucy M. Warren,
  • Jenny Venton,
  • Kenneth C. Young,
  • Mark Halling-Brown,
  • Christopher J. Kelly,
  • Marc Wilson,
  • Megumi Morigami,
  • Lisanne Khoo,
  • Deborah Cunningham,
  • Richard Sidebottom,
  • Mamatha Reddy,
  • Hema Purushothaman,
  • Delara Khodabakhshi,
  • Lesley Honeyfield,
  • Amandeep Hujan,
  • Tsvetina Stoycheva,
  • Andy Joiner,
  • Reena Chopra,
  • Aminata Sy,
  • Dominic Ward,
  • Lin Yang,
  • Rory Sayres,
  • Daniel Golden,
  • Namrata Malhotra,
  • Rachita Mallya,
  • Lihong Xi,
  • Della Ogunleye,
  • Charlotte Purdy,
  • Alistair Mackenzie,
  • Susan Thomas,
  • Shravya Shetty,
  • Fiona J. Gilbert,
  • Ara Darzi,
  • Hutan Ashrafian

摘要

The impact of incorporating artificial intelligence (AI) into a double-read breast-screening workflow, including arbitration, is unclear. This retrospective study included 50,000 representative women from two NHS breast-screening centers. All the women had long-term follow-up, allowing us to determine whether use of AI leads to earlier cancer detection. Cases requiring arbitration (8,732 cases) were read by 22 readers in a reader study, following their normal arbitration workflow. Overall, after arbitration, replacing the second reader with AI was noninferior (5% margin) to two human readers in terms of sensitivity and specificity (P < 0.001) while offering a workload benefit. Arbitration improved the specificity of the AI arm by overruling cases incorrectly recalled by the AI tool; however, it also overruled the AI tool recall decision for some interval and next-round cancers. Further development of the AI tool alongside improvement in its explainability could lead to the earlier detection of cancers.