Spirometry services in England post-pandemic and the potential role of AI support software: a qualitative study of challenges and opportunities

Doe, Gillian; Taylor, Stephanie; Topalovic, Marko; Russell, Richard; Evans, Rachael A.; Maes, Julie; Van Orshovon, Karolien; Sunjaya, Anthony; Scott, David; Prevost, A. Toby; El-Emir, Ethaar; Harvey, Jennifer; Hopkinson, Nicholas S.; Kon, Samantha S.; Patel, Suhani; Jarrold, Ian; Spain, Nannette; Spain, Nanette; Man, William D.C.; Hutchinson, Ann

Abstract

BACKGROUND: Spirometry services to diagnose and monitor lung disease in primary care were identified as a priority in the NHS Long Term Plan, and are restarting post-COVID-19 pandemic in England; however, evidence regarding best practice is limited. AIM: To explore perspectives on spirometry provision in primary care, and the potential for artificial intelligence (AI) decision support software to aid quality and interpretation. DESIGN AND SETTING: Semi-structured interviews with stakeholders in spirometry services across England. METHOD: Participants were recruited by snowball sampling. Interviews explored the pre- pandemic delivery of spirometry, restarting of services, and perceptions of the role of AI. Transcripts were analysed thematically. RESULTS: In total, 28 participants (mean years' clinical experience = 21.6 [standard deviation 9.4, range 3-40]) 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. Four themes were identified: 1) historical challenges in provision of spirometry services; 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; and 4) the potential for AI to have supportive roles in spirometry. CONCLUSION: Stakeholders highlighted historic challenges and the damaging effects of the pandemic contributing to inequity in provision of spirometry, which must be addressed. Overall, stakeholders were positive about the potential of AI to support clinicians in quality assessment and interpretation of spirometry. However, it was evident that validation of the software must be sufficiently robust for clinicians and healthcare commissioners to have trust in the process.

Citation

Doe, G., Taylor, S., Topalovic, M., Russell, R., Evans, R. A., Maes, J., …Hutchinson, A. (2023). Spirometry services in England post-pandemic and the potential role of AI support software: a qualitative study of challenges and opportunities. The British journal of general practice : the journal of the Royal College of General Practitioners, 73(737), e915-e923. https://doi.org/10.3399/BJGP.2022.0608

• Journal Article Type: Article
• Acceptance Date: Jun 26, 2023
• Online Publication Date: Jul 6, 2023
• Publication Date: Dec 1, 2023
• Deposit Date: Jun 27, 2023
• Publicly Available Date: Oct 31, 2023
• Journal: The British journal of general practice : the journal of the Royal College of General Practitioners
• Print ISSN: 0960-1643
• Electronic ISSN: 1478-5242
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Volume: 73
• Issue: 737
• Pages: e915-e923
• DOI: https://doi.org/10.3399/BJGP.2022.0608
• Keywords: Artificial intelligence; Chronic obstructive pulmonary disease; Primary care; Qualitative research; Spirometry; Trust
• Public URL: https://hull-repository.worktribe.com/output/4318636