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)
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Yeji Kim, PhD
- Numero di telefono: +82-10-2724-7740
- Email: lexie6169@gmail.com
Luoghi di studio
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Seoul, Corea del Sud, 07804
- Ewha Womans University Mokdong Hospital
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Contatto:
- Yeji Kim, PhD
- Numero di telefono: +82-10-2724-7740
- Email: lexie6169@gmail.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Diagnostico
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
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Sperimentale: 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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Comparatore attivo: 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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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Diagnostic concordance between the final emergency department diagnosis and the blinded adjudicated reference diagnosis established at hospital discharge.
Lasso di tempo: 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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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Diagnostic concordance after Generative Pre-trained Transformer (GPT)-assisted diagnostic support
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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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Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Pubblicazioni e link utili
Pubblicazioni generali
- 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.
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Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
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Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
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