ER-VISION-AI Study (ER-VISION-AI)
Multimodal Visual Language Model-Assisted Diagnostic Strategy in the Emergency Department: A Prospective Multicenter Randomized Controlled Trial (ER-VISION-AI Study)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Yeji Kim, PhD
- Telefonnummer: +82-10-2724-7740
- E-mail: lexie6169@gmail.com
Studiesteder
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Seoul, Sydkorea, 07804
- Ewha Womans University Mokdong Hospital
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Kontakt:
- Yeji Kim, PhD
- Telefonnummer: +82-10-2724-7740
- E-mail: lexie6169@gmail.com
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Age ≥18 years
- Presentation to a participating emergency department with acute cardiopulmonary symptoms, including chest pain, dyspnea, palpitations, syncope, dizziness, or fever accompanied by cardiopulmonary symptoms
- Performance of both a standard 12-lead electrocardiogram and chest radiography during the initial emergency department evaluation
- Availability of initial clinical assessment, vital signs, laboratory findings, and all mandatory clinical information required for the multimodal AI workflow
- Expected emergency department observation or hospital admission for at least 24 hours
- Ability and willingness to provide written informed consent
Exclusion Criteria:
- Inability or refusal to provide written informed consent
- Requirement for immediate life-saving intervention that precludes completion of the study workflow
- Death before completion of the initial emergency department diagnostic assessment
- Electrocardiographic quality insufficient for reliable physician or Artificial intelligence (AI) interpretation
- Chest radiographic quality insufficient for reliable physician or Artificial intelligence (AI) interpretation
- Cardiac pacing rhythm
- Missing mandatory clinical information required for the multimodal Artificial intelligence (AI) workflow
- Previous enrollment in the ER-VISION-AI trial
- Inability to establish a blinded adjudicated reference diagnosis
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: GPT-assisted multimodal visual language model (VLM) diagnostic strategy
Participants receive physician-supervised Generative Pre-trained Transformer (GPT)-assisted multimodal diagnostic support integrating electrocardiography, chest radiography, structured clinical information, laboratory findings, vital signs, and relevant medical history.
Treating physicians remain responsible for all diagnostic and therapeutic decisions.
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A Generative Pre-trained Transformer (GPT)-based multimodal visual language model integrates electrocardiograms, chest radiographs, structured clinical information, laboratory findings, vital signs, and relevant clinical history to generate diagnostic suggestions and differential diagnoses for physician-supervised clinical decision support.
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Aktiv komparator: Conventional physician-guided diagnostic strategy
Participants undergo standard emergency department diagnostic evaluation according to routine clinical practice without Generative Pre-trained Transformer (GPT)-assisted diagnostic support.
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Routine emergency department diagnostic evaluation performed according to standard clinical practice without AI-assisted diagnostic support.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Diagnostic concordance between the final emergency department diagnosis and the blinded adjudicated reference diagnosis established at hospital discharge.
Tidsramme: During the index hospitalization, up to hospital discharge (average 3 days)
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Diagnostic concordance between the treating physician's final emergency department diagnosis and the blinded adjudicated reference diagnosis based on the prespecified principal diagnostic category.
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During the index hospitalization, up to hospital discharge (average 3 days)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Diagnostic concordance after Generative Pre-trained Transformer (GPT)-assisted diagnostic support
Tidsramme: During the index emergency department visit (average 6 hours)
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Diagnostic concordance between the physician's final emergency department diagnosis after Generative Pre-trained Transformer (GPT)-assisted multimodal diagnostic support and the blinded adjudicated reference diagnosis in participants assigned to the intervention group.
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During the index emergency department visit (average 6 hours)
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Time from emergency department presentation to final diagnosis
Tidsramme: During the index emergency department visit (average 6 hours)
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Time required from emergency department presentation until establishment of the physician's final emergency department diagnosis.
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During the index emergency department visit (average 6 hours)
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Diagnostic reclassification after Generative Pre-trained Transformer (GPT)-assisted evaluation
Tidsramme: During the index emergency department visit (average 6 hours)
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Frequency of changes between the physician's initial working diagnosis and the final emergency department diagnosis after review of Generative Pre-trained Transformer (GPT)-generated diagnostic recommendations.
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During the index emergency department visit (average 6 hours)
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Physician diagnostic confidence
Tidsramme: During the index emergency department visit (average 6 hours)
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Physician-reported diagnostic confidence recorded before and after Generative Pre-trained Transformer (GPT)-assisted diagnostic support using the prespecified study assessment scale.
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During the index emergency department visit (average 6 hours)
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Physician acceptance of Generative Pre-trained Transformer (GPT)-generated diagnostic recommendations
Tidsramme: During the index emergency department visit (average 6 hours)
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Frequency of physician acceptance, modification, or rejection of Generative Pre-trained Transformer (GPT)-generated diagnostic recommendations in the intervention group.
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During the index emergency department visit (average 6 hours)
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Emergency department disposition accuracy
Tidsramme: Up to hospital discharge (average 3 days)
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Accuracy of emergency department disposition decisions, including discharge, hospital admission, or intensive care unit admission, compared with the adjudicated reference diagnosis.
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Up to hospital discharge (average 3 days)
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Emergency department length of stay
Tidsramme: Up to hospital discharge (average 3 days)
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Length of stay in the emergency department measured from patient presentation until emergency department discharge or hospital admission.
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Up to hospital discharge (average 3 days)
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Hospital length of stay
Tidsramme: Up to hospital discharge (average 3 days)
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Total duration of hospitalization from admission until hospital discharge.
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Up to hospital discharge (average 3 days)
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In-hospital mortality
Tidsramme: Up to hospital discharge (average 3 days)
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All-cause mortality occurring during the index hospitalization.
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Up to hospital discharge (average 3 days)
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30-day all-cause mortality
Tidsramme: 30 days
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All-cause mortality occurring within 30 days after the index emergency department visit.
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30 days
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30-day emergency department revisit
Tidsramme: 30 days
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Revisit to any emergency department for any cause within 30 days after the index emergency department visit.
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30 days
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30-day hospital readmission
Tidsramme: 30 days
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Hospital readmission for any cause within 30 days after discharge from the index hospitalization.
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30 days
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Publikationer og nyttige links
Generelle publikationer
- Topol EJ. High-performance medicine: the convergence of human and artificial intelligence. Nat Med. 2019 Jan;25(1):44-56. doi: 10.1038/s41591-018-0300-7. Epub 2019 Jan 7.
- Lopez-Puerta JM, Fernandez-Marin MR, Martin Benlloch JA, Lorente R. Spinal osteoid osteoma recurring as an aggressive osteoblastoma. Neurocirugia (Engl Ed). 2020 May-Jun;31(3):146-150. doi: 10.1016/j.neucir.2019.06.002. Epub 2019 Sep 2. English, Spanish.
- ANCA-associated vasculitis. Nat Rev Dis Primers. 2020 Aug 27;6(1):72. doi: 10.1038/s41572-020-0212-y. No abstract available.
- Kim TH, Kim CH, Choi SG. Radiation-induced angiosarcoma (RIAS) of the maxilla: a case report. J Korean Assoc Oral Maxillofac Surg. 2020 Aug 31;46(4):288-291. doi: 10.5125/jkaoms.2020.46.4.288.
- Li R, Chen X, Wang Y. Adverse events analysis of Relugolix (Orgovyx(R)) for prostate cancer based on the FDA Adverse Event Reporting System (FAERS). PLoS One. 2024 Oct 22;19(10):e0312481. doi: 10.1371/journal.pone.0312481. eCollection 2024.
- Asravor RK. Uncovering the forgotten story of the impact of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome on economic growth in Ghana: A gender analysis. Int J Health Plann Manage. 2023 Sep;38(5):1495-1509. doi: 10.1002/hpm.3675. Epub 2023 Jun 23.
- Shakiba M, Nazemipour M, Mansournia N, Mansournia MA. Protective effect of intensive glucose lowering therapy on all-cause mortality, adjusted for treatment switching using G-estimation method, the ACCORD trial. Sci Rep. 2023 Apr 10;13(1):5833. doi: 10.1038/s41598-023-32855-3.
- Hsu HW, Chiu MC, Shoemaker D, Yang CS. Viral infections in fire ants lead to reduced foraging activity and dietary changes. Sci Rep. 2018 Sep 10;8(1):13498. doi: 10.1038/s41598-018-31969-3.
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
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Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
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