[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-363468-105":3,"doc-detail-363468-en":81,"detail-sidebar-cat-0-en-105":99},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","ai-based-chest-x-ray-prioritization-in-the-lung-cancer-diagnostic-pathway-the-lungimpact-randomized-controlled-trial","AI-based chest X-ray prioritization in the lung cancer diagnostic pathway: the LungIMPACT randomized controlled trial","","AI-based chest X-ray (CXR) prioritization is evaluated for its effect on the lung cancer diagnostic pathway. This prospective, multicentre, randomized controlled trial tested whether immediate AI prioritization of primary care-requested CXR changes time to computed tomography (CT) and subsequent lung cancer diagnosis, compared with no prioritization. In 93,326 analyzed CXR examinations, median time to CT and diagnosis showed no significant differences, and the trial found no impact on referral, treatment timing, or stage at diagnosis. Discordance and actionable findings were assessed across arms.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/ai-based-chest-x-ray-prioritization-in-the-lung-cancer-diagnostic-pathway-the-lungimpact-randomized-controlled-trial/363468/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/ai-based-chest-x-ray-prioritization-in-the-lung-cancer-diagnostic-pathway-the-lungimpact-randomized-controlled-trial/363468.png","ImageObject",300,407,{"name":42,"@type":43},"Grenda","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-25","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the primary outcome of the LungIMPACT randomized controlled trial?","Question",{"text":63,"@type":64},"The primary outcome is time to computed tomography (CT) and lung cancer diagnosis after immediate AI prioritization of abnormal CXRs for reporting.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Did AI prioritization change the time to CT or lung cancer diagnosis?",{"text":68,"@type":64},"No significant differences were observed in median time to CT or in time to lung cancer diagnosis between AI prioritization and no prioritization groups.",{"name":70,"@type":61,"acceptedAnswer":71},"What did the trial conclude about implementing AI CXR deployments in this setting?",{"text":72,"@type":64},"AI prioritization of UK primary care-requested CXR had no significant impact on the lung cancer pathway, so deployments in this context should not include worklist prioritization. Future research should separate direct AI effects from pathway changes.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},363468,1790448548,{"code":4,"msg":82,"data":83},"success",{"doc_id":79,"user_id":84,"nickname":42,"user_avatar":85,"doc_module":4,"category_id":86,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":87,"file_id":88,"file_url":89,"file_type":90,"file_size":91,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":92,"language":93,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":94,"faqs":95,"seo_title":96,"seo_description":12,"update_tm":97,"read_time":98},7971474921005,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0",7,"| nature medicine |  | |\n| --- | --- | --- |\n| Article [https://doi.org/10.1038/s41591-026-04253-5](https://doi.org/10.1038/s41591-026-04253-5) |  |  |\n| AI-based chest X-ray prioritization in the lung cancer diagnostic pathway: the LungIMPACT randomized controlled trial |  |  |\n| Received: 6 October 2025\u003Cbr>Accepted: 26 January 2026\u003Cbr>Published online: 24 March 2026  Check for updates | A list of authors and their affiliations appears atthe end of the paper\u003Cbr>Prioritizing artificial intelligence (AI)-detected imaging findings may reduce the time to diagnosis of lung cancer. This prospective, multicentre, randomized controlled trial tested whether immediate AI prioritization of primary care-requested chest X-rays (CXR) influenced time to computed tomography (CT) and lung cancer diagnosis, the primary outcomes. Secondary outcomes included the number of urgent suspected lung cancer referrals, incidence and stage of lung cancer, times to urgent referral and treatment, concordance between AI and radiology reports, and algorithm accuracy. AI was available in both study arms, with AI prioritization randomized by day. Of 97,731 participant CXRs, 4,405 were excluded due to data compliance issues or failure of randomization, resulting in 93,326 CXRs analyzed (45,987 and 47,339 in the prioritization ‘on’or ‘off’ arms, respectively). Atotal of 13,347 CTs were identified, with 2,766 performed within 14 days of CXR. Median (interquartile range) timesto CT were 53 days (17–145) and 53 days (19–141), with and without AI prioritization, corresponding toa ratio of geometric means of 0.97 (95% confidence interval (CI) = 0.93–1.02; P = 0.31). When restricted to CTs performed within 14 days of CXR, the median time to CTwas 8 days (5–11) in both groups. Lung cancer was diagnosed in 558 people (0.6% of CXRs). Median times to diagnosis were 44 days (26–90) and 46 days (24–105) respectively, with a ratio of geometric means of 0.98 (95% CI = 0.83–1.16; P = 0.84). No significant differences were observed in time to lung cancer referral (14 versus 15 days; P = 0.13), time to treatment (76 versus 72.5 days; P = 0.99) or stage at diagnosis (P = 0.34). Discordance between AI and radiology reports occurred in 28,261 CXRs (30.3%) and expert radiology review identified actionable findings in 6,750 cases (23.9%). AI prioritization of CXR requested by UK primary care has no significant impact on the lung cancer pathway. Therefore, CXRAI deployments should not\u003Cbr>include worklist prioritization in this context. Future research should differentiate between primary pathway changes and the direct impact of AI. ISRCTN registration: 78987039. |  |\n\n[e-mail:](e-mail: david.baldwin12@nhs.net)[ david.baldwin12@nhs.net](e-mail: david.baldwin12@nhs.net)  \nLung cancer accounts for the highest proportion of cancer-related deaths in the United Kingdom (UK) and worldwide, primarily because it is common, is diagnosed at a late stage and/or late in the symptomatic period when patients have become too unwell for treatment. Survival rates in the UK are lower than those from high-income countries with comparable cancer registration data and it is thought that much of this is due to later diagnosis1–3. Diagnostic pathway delay can worsen outcomes in both early-stage and late-stage disease and increase patient and carer anxiety4–6. Patient feedback gathered from focus groups conducted during the study also supports the need for timely reporting. Patients who undergo investigations are often anxious about the results, with research suggesting that the time between testing and receiving the results is particularly worrying7–10.  \nNational cancer care pathways provide a method to accelerate and standardize the end-to-end patient journey11,12. In England, the National Optimal Lung Cancer Pathway (NOLCP) recommends rapid progression from chest X-ray (CXR) to computed tomography (CT), followed by assessment in a specialist clinic. The NOLCP mandates that patients with a suspicious CXR u","cbCaipLdMLmzNUho","https://ap.wps.com/l/cbCaipLdMLmzNUho","pdf",5375383,21,"English","# Background and rationale\n## National pathway and delay drivers\n## Role of AI in assisted CXR reporting\n# Trial design and methods\n## Primary and secondary outcomes\n## Participant flow and analysis\n# Results\n## Time to CT\n## Time to lung cancer diagnosis\n## Pathway steps and clinical outcomes\n## AI–radiology concordance and actionable findings\n# Conclusions and future directions","[{\"question\":\"What is the primary outcome of the LungIMPACT randomized controlled trial?\",\"answer\":\"The primary outcome is time to computed tomography (CT) and lung cancer diagnosis after immediate AI prioritization of abnormal CXRs for reporting.\"},{\"question\":\"Did AI prioritization change the time to CT or lung cancer diagnosis?\",\"answer\":\"No significant differences were observed in median time to CT or in time to lung cancer diagnosis between AI prioritization and no prioritization groups.\"},{\"question\":\"What did the trial conclude about implementing AI CXR deployments in this setting?\",\"answer\":\"AI prioritization of UK primary care-requested CXR had no significant impact on the lung cancer pathway, so deployments in this context should not include worklist prioritization. Future research should separate direct AI effects from pathway changes.\"}]","AI-based chest X-ray prioritization in the lung cancer diagnostic pathway: the LungIMPACT randomized controlled trial | PDF",1790151334,53,{"code":4,"msg":82,"data":100},[101,105,109,113,118,123,126,130,135,138,142],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},"Exam",70,"exam",{"id":114,"doc_module":4,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},5,"Comic",60,"comic",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},6,"Technology",50,"technology",{"id":86,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":124,"slug":125},40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":127,"show_sort_weight":128,"slug":129},"Research & Report",30,"research-report",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":133,"slug":134},9,"Religion & Spirituality",20,"religion-spirituality",{"id":133,"doc_module":4,"doc_module_name":25,"category_name":136,"show_sort_weight":133,"slug":137},"World Cup","world-cup",{"id":139,"doc_module":4,"doc_module_name":25,"category_name":140,"show_sort_weight":139,"slug":141},10,"Lifestyle","lifestyle",{"id":143,"doc_module":4,"doc_module_name":25,"category_name":144,"show_sort_weight":114,"slug":145},19,"General","general"]