Challenges and opportunities in resuming spirometry services in England post-pandemic with potential to adopt Artificial Intelligence decision support software: a qualitative study. (ID 439)
University of Leicester
Funding: The study is being funded by National Institute for Health Research (NIHR) through an AI Award in Health and Care (Phase 3- Application: Grant number AI_AWARD02204). The study is also supported by the NIHR Leicester Biomedical Research Centre – Respiratory theme. ST is supported by the National Institute for Health Research ARC North Thames. RR is supported by the NIHR Oxford Biomedical Research Centre – Respiratory. RAE is supported by an NIHR Clinical Scientist fellowship. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Abstract
Aim: To explore perspectives on spirometry provision in primary care in England post-pandemic, and the potential for Artificial Intelligence (AI) decision support software to aid quality and interpretation in future pathways.Methods: Semi-structured interviews were conducted with key stakeholders in spirometry services across England. Participants were recruited by snowball sampling starting with existing contacts in respiratory special interest groups. Interviews explored the pre-pandemic delivery of spirometry, restarting of services and perceptions of the role of AI. Transcripts were analysed using thematic analysis supported by NVivo software.
Results: 28 participants (mean [SD], 21.6 [9.4, range 3-40] years’ clinical experience) were interviewed between April and June 2022. Participants included clinicians (n=25) and commissioners (n=3); eight held regional and/or national respiratory network advisory roles. Geographical spread of interviewees across England included the North West, North East, Midlands, South West and London.
Four themes were identified (Figure 1): 1) Historical challenges in spirometry provision; 2) Inequity in post-pandemic spirometry provision and challenges to restarting spirometry in primary care; 3) Future delivery closer to patients’ homes by appropriately trained staff; 4) The potential for AI to have supportive roles in spirometry.
There was an overall sense of urgent need to improve services. All participants expressed the importance of spirometry being accessible for patients. Despite some hesitancy around AI, GPs in particular were keen to explore its potential.
Conclusion: Stakeholders highlighted historic challenges and the damaging effects of the pandemic contributing to inequity in provision of spirometry nationally. To improve equitable access to spirometry in primary care, services must be accessible for patients and delivered by appropriately trained staff. Opportunities arise to reconsider pathway design with potential for AI to support workforce capacity, quality assurance and interpretation. It was evident that validation of the AI software must be sufficiently robust to have trust in the process.
A similar Abstract was submitted and presented to IPCRG Munich, May 2023.
Conflicts of interest: WM is Honorary President of the Association for Respiratory Technology and Physiology (ARTP). MT is CEO of ArtiQ – a company that produces artificial intelligence enabled lung function support software. JM and KVO are employees of ArtiQ.
The conference has been instigated and organised by PCRS. We are grateful to sponsors and exhibitors who have contributed funding towards this event in return for exhibition space. Neither sponsors or exhibitors have had any input into the agenda or the selection of speakers with the exception of any sponsored satellite symposia which are clearly indicated. View the full list of sponsors.