Impact of the Implementation of a National AI Technology Programme on Cardiovascular Outcomes and the Health System, 2021-2024

In 2018, NHS England introduced a new Artificial Intelligence (AI) decision support technology into the health system in order to improve the diagnostic pathway of patients who were being investigated for suspected coronary artery disease.

The primary aim of the FISH and CHIPS study was to assess the impact of this health intervention by determining the differences in health-related events of a stable chest pain population undergoing Coronary Computed Tomography Angiography (CCTA) and Fractional Flow Reserve (FFR-CT), compared to a previous ‘standard of care’ diagnostic chest pain pathway of CCTA and non-invasive functional testing.

This is a multi-centre, retrospective, observational analytic cohort study design. The study utilised the electronic health record (EHR) data already collected by NHS England on all patients that underwent a CCTA for the assessment of coronary artery disease over a 3-year period (April 2017-April 2020). All patients were treated in accordance with the latest NICE clinical guidance (CG 95 2016). Healthcare data was used to determine clinical outcomes (heart attacks, death, cardiac death), procedures performed (invasive angiography, percutaneous stenting and surgical bypass grafting) and heart diagnostic tests up to 24 months following the index CCTA. Costs are determined from the NHS national tariff system.