Table 1. Summary table of study objectives and outcomes.

Primary objective	Outcome measures
To assess the clinical effectiveness of qXR to prioritise patients that have suspected lung cancer (identified from AI analysis of a chest X-ray (CXR)) for follow-up CT	Time to ‘decision to recommend CT’, or a decision not to undergo CT for CXR acquired with USC (CXR acquired to CXR reported)
Secondary objectives
Assess the potential utility of qXR within the optimised lung cancer pathway in terms of the impact on both patient treatment and radiological workflow	Time from acquisition of CXR to reporting Time to reporting of CXR classified as USC or other Time to diagnosis of lung cancer Time to treatment initiation for lung cancer Number of hospital visits during screening pathway Hospitalisation within 6 and 12 months of CXR acquisition Death within 6 and 12 months of CXR acquisition
To assess the safety (false-negative rate) of qXR at ruling out patients from entry onto the cancer pathway	Percentage of CXRs not identified by qXR as suspected lung cancer that the radiologist refers for CT for USC Percentage of non-USC that are referred for CT with subsequent detection of lung cancer
To evaluate the technical performance of qXR	Model performance, for example, sensitivity, specificity, positive and negative predictive values
To conduct a Health Economic Assessment of qXR.	Compare costs and health benefits between pre- and post-implementation of qXR
To assess the acceptability of qXR among NHS service users and staff.	Provide an in-depth understanding of the acceptability of qXR among key stakeholders

USCUrgent Suspicion of Cancer