Early value assessment (EVA) guidance on artificial intelligence (AI)-derived software to analyse chest X-rays for suspected lung cancer in primary care referrals.

The Department of Health and Social Care and NHS England have launched several initiatives that will support the generation of more evidence for the use of AI technologies. This includes:

The AI Diagnostic Fund: In June 2023, DHSC announced funding for the creation of a ring-fenced £21 million AI diagnostics fund. One area of focus of the fund is AI to support radiologists to read chest X-rays. DHSC, the National Institute for Health and Care Research (NIHR) and NHS England are collaborating to support the winning trusts to do 'in-service evaluations'. These evaluations, alongside plans for national collation of data and metrics from the deployments across multiple imaging networks, aim to answer the evidence gaps set out in the guidance and evidence generation plan.

The AI Deployment Platform: DHSC is piloting a platform to help deploy multiple AI imaging technologies in radiology, in 2 NHS imaging networks. This may include those for chest X-rays. As part of this work, a mechanism will be set up to support the post-market surveillance of these AI models in clinical practice.


NICE has developed tools and resources, in association with relevant stakeholders, to help organisations put this guidance into practice, including an evidence generation plan. The evidence generation plan gives further information on the prioritised evidence gaps and outcomes, ongoing studies and potential real-world data sources. It includes how the evidence gaps could be resolved through real-world evidence studies.

Guidance development process

Early value assessment (EVA) guidance rapidly provides recommendations on promising health technologies that have the potential to address national unmet need. NICE has assessed early evidence on these technologies to determine if earlier patient and system access in the NHS is appropriate while further evidence is generated.

The diagnostics advisory committee has considered the evidence and the views of clinical and patient experts.

How we develop NICE early value assessment guidance

This guidance updates and replaces NICE’s medtech innovation briefing on artificial intelligence for analysing chest X-ray images (MIB292).

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)