aceClinical usability of an explainable AI decision support tool and evaluation of multimodal models in NSCLC
Despite a decade in, immunotherapy (IO) treatment selection in non-small cell lung cancer (NSCLC) remains largely guided by subgroup analyses and imperfect programmed death ligand 1 (PD-L1) and clinical scores. To our knowledge, I 3 LUNG ( NCT05537922 ) is currently the largest international, real-world, multimodal, artificial intelligence (AI)-based study, enrolling 2,396 patients. We integrated real-world clinical and blood (CB) data, computed tomography (CT) images, digital pathology (DP), and genomics into m…
In NSCLC immunotherapy selection, CB-only AI models outperformed PD-L1 and clinical scores in the independent test set, and both expert and nonexpert physicians improved their predictions when using the explainable AI decision support tool.
AI model performance dropped in external validation to AUC 0.55-0.72, and multimodal integration did not show translated incremental benefit in TEST and EXVAL sets.
External generalizability is limited by performance drop in external validation and uncertain incremental benefit of multimodal fusion, which did not translate in TEST and EXVAL.
Evidence
- Peer-reviewedNature Medicine2026-09-13
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Truvace Impact Record TRV-2026-1095, v1: “Clinical usability of an explainable AI decision support tool and evaluation of multimodal models in NSCLC.” Truvace, 2026-09-15. /record/TRV-2026-1095 (accessed at citation time). sha256 439de0637552e79c…
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