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AI-assisted Rare Disease Diagnosis

30. Juli 2026 aktualisiert von: Shuyang Zhang, MD, PhD, Peking Union Medical College Hospital

A Multicentre Randomised Controlled Trial of LLM-Assisted Diagnostic Support in Patients With Suspected Rare or Diagnostically Unresolved Disease

A multicentre randomised controlled trial evaluating whether a rare-disease diagnostic large language model can improve diagnostic quality, efficiency, and health-economic outcomes for physicians managing patients with suspected rare or diagnostically unresolved disease.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Rare disease patients commonly experience prolonged diagnostic odysseys rooted in limited rare disease recognition, phenotypic heterogeneity, and dispersed diagnostic clues. Diagnostic decision-support large language models may improve first-visit consultations by integrating prior records, generating structured analyses, and proposing candidate diagnoses, thereby shortening diagnostic pathways and improving appropriate genetic testing referral.

Participating physicians will provide care under both AI-assisted and standard diagnostic workflows. Eligible patients will be individually randomised to receive either AI-assisted diagnostic support or standard clinical practice.

In the intervention arm, physicians will have diagnostic support from AI when seeing patients. In the control arm, patients are seen under standard hospital workflow without any generative AI tools. Outcomes adjudicated by an independent Expert Committee blinded to arm assignment; adjudicators access no AI-generated materials.

A prospective within-trial economic evaluation will be conducted alongside the randomized trial. Healthcare resource use and costs associated with the diagnostic pathway will be collected.

Studientyp

Interventionell

Einschreibung (Geschätzt)

1056

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

  • China
      • Beijing, China
        • Peking Union Medical College Hospital
        • Kontakt:
      • Cangzhou, China
        • Cangzhou Central Hospital
        • Kontakt:
      • Changchun, China
        • Changchun Sacred Heart Hospital
      • Dongguan, China
        • Dongguan People's Hospital
      • Foshan, China
        • First People's Hospital of Foshan
      • Guiyang, China
        • Guizhou Provincial People's Hospital
      • Jilin City, China
        • Jilin Central General Hospital
      • Kunming, China
        • The First People's Hospital of Yunnan Province
      • Tianjin, China
        • Tianjin Children's Hospital
      • Tianshui, China
        • Tianshui 407 Hospital
        • Kontakt:
      • Wuhai, China
        • Wuhai People's Hospital
      • Xining, China
        • Qinghai Provincial People's Hospital
      • Zhangzhou, China
        • Zhangzhou Municipal Hospital of Fujian Province

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Kind
  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Patient Inclusion Criteria:

  • Any age. Legal guardian co-signs consent for minors or individuals lacking legal capacity.
  • Diagnostically unresolved or suspected rare disease, with at least one prior complete clinical evaluation at a secondary-level or higher institution yielding no confirmed explanatory diagnosis.
  • First presentation to the enrolling institution for the current condition, with no prior records in the institutional HIS or outpatient system.
  • No prior genetic testing related to the current condition; no results or reports available.
  • Written informed consent provided voluntarily by patient or legal guardian, with commitment and ability to complete structured follow-up.

Patient Exclusion Criteria:

  • Confirmed diagnosis (clinical, pathological, or molecular) explaining the primary symptoms.
  • Emergency presentation, critical illness, or any condition incompatible with trial participation.
  • Neither patient nor legally authorised proxy able to complete follow-up.
  • Concurrent enrollment in another interventional study with diagnostic accuracy or genetic testing yield as a primary endpoint.
  • Prior use of another AI system has already yielded a confirmed diagnosis for the current condition.

Physician Inclusion Criteria

  • Licensed physician in internal medicine, neurology, pediatrics, general medicine, rare disease, or a related specialty.
  • ≥2 years of clinical practice; competent to manage rare disease patients; stratified into junior or senior tier.
  • Voluntary participation with written informed consent.

Physician Exclusion Criteria

  • No longer in clinical practice, or unable to fulfill required outpatient duties during the study period.
  • Unwilling to provide informed consent or to permit protocol-required collection of consultation and questionnaire data.
  • Currently enrolled in another AI-assisted clinical workflow, or expected to be unable to comply with the procedures.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Diagnose
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: AI system
AI system will be used to provide diagnostic support during the encounter in addition to conventional clinical workflow. Use of other generative AI tools is prohibited.
Sonstiges: AI system
The study AI system will be used to provide diagnostic support during the clinical encounter, including structuring relevant clinical information, generating a clinical analysis, and suggesting candidate diagnoses for review by the treating physician.
Kein Eingriff: Standard of care
The physician conducts the encounter per standard hospital workflow using conventional clinical resources only. Use of any generative AI tool is prohibited.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Overall Correct Diagnostic Yield
Zeitfenster: From the first visit to final reference diagnosis adjudication, an average of 8 weeks.
The proportion of all randomised patients whose clinical diagnosis by the end of follow-up is concordant with the blinded-adjudicated final reference diagnosis determined by an independent committee.
From the first visit to final reference diagnosis adjudication, an average of 8 weeks.

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Physician-Reported Experience
Zeitfenster: Assessed at each consultation (day 1), within 1 day.
Physicians will assess their experience of the diagnostic workflow. Responses will be recorded using a standardized rating scale (range 1-5, where higher scores indicate more positive experience).
Assessed at each consultation (day 1), within 1 day.
Patient-Reported Experience
Zeitfenster: Assessed at each consultation (day 1), within 1 day.
Patients will assess their experience of the diagnostic workflow. Responses will be recorded using a standardized rating scale (range 1-5, where higher scores indicate more positive experience).
Assessed at each consultation (day 1), within 1 day.
Appropriate Genetic Testing Recommendation Rate
Zeitfenster: From the initial consultation to genetic testing indication adjudication, approximately 8 weeks
The proportion of randomized patients for whom physician-recommended genetic testing is concordant with the indication determined by an independent genetics adjudication committee.
From the initial consultation to genetic testing indication adjudication, approximately 8 weeks
Candidate Diagnostic Accuracy
Zeitfenster: From the first visit to final reference diagnosis adjudication, an average of 8 weeks.
The agreement between physician-provided candidate diagnoses in the the initial consultation and the independently adjudicated reference diagnosis.
From the first visit to final reference diagnosis adjudication, an average of 8 weeks.
Molecular Diagnostic Yield
Zeitfenster: From the first visit to final reference diagnosis adjudication, an average of 8 weeks.
The proportion of all randomized patients in whom genetic testing performed as part of the clinical diagnostic pathway identifies a clinically relevant molecular finding that is confirmed through independent genetics review.
From the first visit to final reference diagnosis adjudication, an average of 8 weeks.
Time to a Correct Diagnosis
Zeitfenster: From enrollment to the end of follow-up, up to 8 weeks.
The number of days from the first study visit to the first physician-assigned diagnosis that is subsequently confirmed as concordant with the independently adjudicated reference diagnosis.
From enrollment to the end of follow-up, up to 8 weeks.
Duration of the Initial Physician Consultation
Zeitfenster: Assessed at each consultation (day 1), within 1 day.
In-room consultation time will be recorded, measured, and compared between arms.
Assessed at each consultation (day 1), within 1 day.

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Peking Union Medical College Hospital

Mitarbeiter

Guizhou Provincial People's Hospital
First People's Hospital of Foshan
Dongguan People's Hospital
Qinghai People's Hospital
Cangzhou Central Hospital
The First People's Hospital of Yunnan
Tianjin Children's Hospital
Zhangzhou Municipal Hospital

Ermittler

  • Hauptermittler: Shuyang Zhang, MD, PhD, Peking Union Medical College Hospital

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. August 2026

Primärer Abschluss (Geschätzt)

1. Juli 2027

Studienabschluss (Geschätzt)

1. Dezember 2027

Studienanmeldedaten

Zuerst eingereicht

7. Juni 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

14. Juni 2026

Zuerst gepostet (Tatsächlich)

16. Juni 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

31. Juli 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

30. Juli 2026

Zuletzt verifiziert

1. Juli 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • PUMCH I-26PJ0002

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

De-identified IPD will be shared with qualified researchers upon reasonable request, subject to ethics approval and a data use agreement.

IPD-Sharing-Zeitrahmen

Beginning 6 months after publication of the primary study results and ending 5 years after publication.

IPD-Sharing-Zugriffskriterien

Requests must include a scientifically sound research proposal and analysis plan, and evidence of ethics approval or exemption where applicable. Access will be subject to approval by the study steering committee and participating institutions, execution of a data use agreement, and compliance with applicable ethical, legal, and data-protection requirements. Data will be made available through a secure access environment or other controlled transfer mechanism. No directly identifiable participant information will be shared.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ANALYTIC_CODE

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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