Britain's National Health Service (NHS) is famous for offering free medical treatment to all UK citizens. Despite this, uptake of some services remains low, particularly in certain ethnic demographics. The British government has spent many years trying to reduce these inequalities – and now they are investigating how artificial intelligence (AI) can help bridge the gap. NHSx – the NHS' AI lab and health foundation – has a mission "to ensure NHS patients are amongst the first in the world to benefit from leading AI," and "a responsibility to ensure those technologies don't exacerbate existing health inequalities." As part of these efforts, NHSx has recently identified four AI projects that will benefit from additional investment.

The paper looks at a specific clinical example of the disparities that exist in the treatment of knee osteoarthritis, an ailment which causes chronic pain. Assessing the severity of that pain helps doctors prescribe the right treatment, including physical therapy, medication, or surgery. This is traditionally done by a radiologist reviewing an X-ray of the patient's knee and scoring their pain on the Kellgren–Lawrence grade (KLG), which calculates pain levels based on the presence of different radiographic features, like the degree of missing cartilage or structural damage. But data collected by the National Institute of Health found that doctors using this method systematically score Black patients far below the severity of pain that they say they're experiencing. Patients self-report their pain levels using a survey that asks about pain during various activities, such as fully straightening their knee.