Why did NICE not Recommend AI for CXR Reading in the UK?

The National Institute for Health and Care Excellence (NICE), which advises the National Health Service (NHS) on cost-effective resource allocation, introduced its Early Value Assessment (EVA) pathway in 2020 to accelerate access to promising digital and artificial intelligence (AI) technologies while further evidence is generated. However, one of the first EVA cohorts not to receive a conditional recommendation comprised 13 AI tools designed to support interpretation of chest X-rays (CXR) for suspected lung cancer in primary care referrals. This manuscript examines the rationale for that decision through narrative policy analysis of NICE guidance and committee documentation, contextualized within the UK health technology assessment framework.