- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05117320
Artificial Intelligence to Improve Physicians' Interpretation of Chest X-Rays in Breathless Patients (XRAI)
Artificial Intelligence to Improve Chest X-ray Reading in Acute Dyspnoeic Patients: A Randomized Controlled Trial
Study Overview
Detailed Description
Background:
Acute dyspnoea is a common symptom in the emergency department (ED) but possible differential diagnoses are numerous. The chest X-ray (CXR) is of great importance in distinguishing between these diagnoses and initiating proper treatment but is challenging to interpret for non-radiologist physicians. Radiology departments are confronted with a demand to read a constantly increasing number of acutely performed CXRs, which exceeds the necessary resources. Therefore, in the acute setting, emergency physicians must often read and diagnose the CXR alone. Altogether, there is an unmet need for help with the CXR interpretation in the ED.
Artificial intelligence (AI) software for interpreting CXR has been developed for the detection of pathological findings. In this study, the primary aim is to investigate if AI improves the diagnosis on CXR by non-radiologist physicians in consecutive dyspnoeic patients in the emergency department.
The investigators hypothesize, that AI applied to chest X-rays improves the emergency physicians' diagnostic accuracy in acute dyspnoeic patients. The study has the potential to impact the implementation of AI in clinical practice.
Method:
In a randomized, controlled cross-over study and multi-reader multi-case study, a total of 33 emergency physicians will review CXRs from 231 prospectively collected patients including vital patient information. Each physician will review data from 46 patients. In random order, and on two different days, each CXR is reviewed once with and once without AI-support. Each physician is asked to assess a diagnosis of heart failure, a diagnosis of pneumonia, and whether the CXR is with or without acute remarkable findings. The reference standard is the radiological diagnoses obtained by two independent thorax radiologists blinded to all clinical data.
The physicians report their diagnoses in an online questionnaire based on REDCap®. Information that may affect diagnostic accuracy are also collected, such as level of education and experience with CXR reading, along with questions about how sure the physician feels of their tentative diagnosis. The physicians are asked about their interest in, former experience with and expectations to AI, along with an evaluation of these qualities afterwards.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Copenhagen, Denmark
- University Hospital Bispebjerg and Frederiksberg
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Medical Doctor (MD)
- Working experience with emergency patients
Exclusion Criteria:
- Current or former employment as a radiologist
- Unwillingness to consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: AI support
|
Images were allocated to participants.
In randomized allocation, one half of the images for each participant are viewed with AI support and the other half is viewed without AI support on the first trial day.
On the second trial day the same images are viewed without versus with AI, respectively.
This ensures that all images are read twice by the same participant both with and without AI support.
Other Names:
|
No Intervention: Non-AI support
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Accuracy of diagnosing ADHF on acute CXR with vs without AI
Time Frame: 3 months
|
The primary outcome is the difference in diagnostic accuracy of the non-radiologist physicians' diagnosis of ADHF on acute CXR compared with the gold standard.
Odds of correct diagnosis are compared using an odds ratio with 95% confidence interval estimated using conditional logistic regression stratified by each image with and without AI.
Thus, the improvement in the odds of correct classification after versus before AI support is reported.
The significance level is 0.025.
|
3 months
|
Accuracy of diagnosing pneumonia on acute CXR with vs without AI
Time Frame: 3 months
|
The primary outcome is the difference in diagnostic accuracy of the non-radiologist physicians' diagnosis of pneumonia on acute CXR compared with the gold standard.
Odds of correct diagnosis are compared using an odds ratio with 95% confidence interval estimated using conditional logistic regression stratified by each image with and without AI.
Thus, the improvement in the odds of correct classification after versus before AI support is reported.
The significance level is 0.025.
|
3 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- FACTUAL-XRAI 1.0
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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