Deze pagina is automatisch vertaald en de nauwkeurigheid van de vertaling kan niet worden gegarandeerd. Raadpleeg de Engelse versie voor een brontekst.

Large Language Model Assistance for Clinical Decision-Making Among Rural Physicians

14 juli 2026 bijgewerkt door: tao liyuan, Peking University Third Hospital

Effect of Large Language Model Assistance on Clinical Decision-Making Among Rural Physicians: A Randomized Controlled Trial

This study will evaluate whether, relative to conventional information retrieval approaches, direct large language models (LLM) access and LLM use training can improve the overall clinical decision-making ability of rural physicians in low-resource grassroots healthcare settings.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Rural physicians play an essential role in the diagnosis and management of common and frequently occurring conditions, referral decision-making, chronic disease management, and patient education. In resource-constrained primary care settings, they often face limited access to medical information and specialist support, delays in updating clinical knowledge and guidelines, and substantial pressure in clinical decision-making. These challenges are particularly relevant in northwestern China, where primary care resources are relatively limited. Improving rural physicians' abilities in diagnostic assessment, recognition of clinical warning signs, and rational prescribing is therefore an important priority for strengthening primary healthcare services.

Large language models (LLMs) can support medical information retrieval, organization of diagnostic and management approaches, differential diagnosis, medication-related decision-making, patient education, and follow-up planning, and may therefore serve as accessible tools for supporting clinical decision-making in primary care. However, general-purpose LLMs were not specifically developed for use in resource-constrained primary care settings and have not been adequately evaluated among rural physicians. Their responses may contain factual errors or fabricated evidence, overlook warning signs, provide insufficient medication safety warnings, or recommend investigations and treatments that are not feasible in local primary care settings. Without adequate verification skills, physicians may fail to benefit from LLM assistance and may even introduce new safety risks. It is therefore important to evaluate how rural physicians use LLMs and whether structured training can improve the safe and effective use of these tools before their wider implementation.

This randomized controlled trial will evaluate the effects of LLM assistance and brief training on clinical decision-making among rural physicians. Participants will complete clinical cases involving common conditions encountered in primary care, with tasks assessing diagnostic judgment, recognition of warning signs, rational treatment, and patient education. Some participants will also use the LLM as a second-opinion tool to review and revise their initial decisions. All responses will be independently evaluated by reviewers blinded to group assignment using standardized scoring criteria to assess overall clinical decision-making performance and safety.

Studietype

Ingrijpend

Inschrijving (Geschat)

240

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

  • China
    • Xinjiang Uygur Autonomous Region
      • Karamay, Xinjiang Uygur Autonomous Region, China
        • Xinjiang Second Medical College
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Ja

Beschrijving

Inclusion Criteria:

  • Currently engaged in clinical practice at a rural primary healthcare institution in northwestern China.
  • Has received formal medical education and holds a relevant diploma or degree.
  • Able to read and understand clinical case materials in Chinese.
  • Able to use a computer to complete the study tasks.
  • Willing to participate and able to provide written informed consent.

Exclusion Criteria:

  • Previously involved in the development of the clinical case tasks, reference answers, or scoring rubric for this study.
  • Previously participated in pilot testing involving the same clinical case tasks or study procedures.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Onderzoek naar gezondheidsdiensten
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Faculteitstoewijzing
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: Conventional Resources Followed by LLM Second Opinion
Participants receive no LLM-use training. During the initial 60-minute assessment, they complete the clinical cases using conventional non-LLM resources only. After submitting their initial responses, they receive an additional 30 minutes to use the study-provided LLM as a second-opinion tool to review and revise their responses.
Ander: Conventional Non-LLM Resources
During the initial 60-minute assessment, participants complete primary care clinical cases using conventional non-LLM resources only, including clinical guidelines, textbooks, drug labels, training materials, medical websites, and standard search engines. Participants are not permitted to use LLMs during this phase.
Ander: LLM Second-Opinion Review
After completing and submitting their initial responses using conventional non-LLM resources, participants receive an additional 30 minutes to use the study-provided DeepSeek-V4 as a second-opinion tool. They may review, verify, and revise their initial clinical decisions before submitting their final responses.
Experimenteel: Direct LLM Assistance
Participants receive no LLM-use training and may use the study-provided LLM throughout the initial 60-minute assessment to complete the clinical cases. They submit their final responses at 60 minutes and do not participate in the additional second-opinion phase.
Ander: Direct LLM Assistance
During the initial 60-minute assessment, participants may use the study-provided DeepSeek-V4 to assist with medical information retrieval, diagnostic and management reasoning, identification of warning signs, referral decisions, rational prescribing, patient education, and follow-up planning. Participants remain responsible for their final clinical decisions and responses.
Experimenteel: LLM Training and Conventional Resources Followed by LLM Second Opinion
Participants receive brief structured training on the safe and effective use of LLMs. During the initial 60-minute assessment, they complete the clinical cases using conventional non-LLM resources only. After submitting their initial responses, they receive an additional 30 minutes to use the study-provided LLM as a second-opinion tool to review and revise their responses.
Ander: Conventional Non-LLM Resources
During the initial 60-minute assessment, participants complete primary care clinical cases using conventional non-LLM resources only, including clinical guidelines, textbooks, drug labels, training materials, medical websites, and standard search engines. Participants are not permitted to use LLMs during this phase.
Ander: LLM Second-Opinion Review
After completing and submitting their initial responses using conventional non-LLM resources, participants receive an additional 30 minutes to use the study-provided DeepSeek-V4 as a second-opinion tool. They may review, verify, and revise their initial clinical decisions before submitting their final responses.
Gedragsmatig: LLM-Use Training
Before completing the clinical cases, participants receive brief structured training on the safe and effective use of LLMs. The training covers the role and limitations of LLMs, structured prompting and follow-up questioning, identification of warning signs and referral indications, medication safety, verification of LLM-generated information, high-risk situations in which LLMs should not be relied upon, and protection of patient privacy.
Experimenteel: LLM Training and Direct LLM Assistance
Participants receive brief structured training on the safe and effective use of LLMs and may use the study-provided LLM throughout the initial 60-minute assessment to complete the clinical cases. They submit their final responses at 60 minutes and do not participate in the additional second-opinion phase.
Ander: Direct LLM Assistance
During the initial 60-minute assessment, participants may use the study-provided DeepSeek-V4 to assist with medical information retrieval, diagnostic and management reasoning, identification of warning signs, referral decisions, rational prescribing, patient education, and follow-up planning. Participants remain responsible for their final clinical decisions and responses.
Gedragsmatig: LLM-Use Training
Before completing the clinical cases, participants receive brief structured training on the safe and effective use of LLMs. The training covers the role and limitations of LLMs, structured prompting and follow-up questioning, identification of warning signs and referral indications, medication safety, verification of LLM-generated information, high-risk situations in which LLMs should not be relied upon, and protection of patient privacy.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Overall Clinical Decision-Making Score
Tijdsspanne: At the end of the initial 60-minute assessment
Participants' responses to primary care clinical cases will be evaluated using a prespecified scoring rubric. The overall score will reflect performance across key components of clinical decision-making. Higher scores indicate better overall clinical decision-making performance.
At the end of the initial 60-minute assessment

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Diagnostic Judgment Domain Score
Tijdsspanne: At the end of the initial 60-minute assessment
Participants' diagnostic judgment in response to primary care clinical cases will be evaluated using a predefined scoring rubric. Higher scores indicate better diagnostic judgment.
At the end of the initial 60-minute assessment
Clinical Warning Sign Recognition Domain Score
Tijdsspanne: At the end of the initial 60-minute assessment
Participants' ability to identify clinically important warning signs in primary care clinical cases will be evaluated using a predefined scoring rubric. Higher scores indicate better recognition of clinical warning signs.
At the end of the initial 60-minute assessment
Treatment Plan Domain Score
Tijdsspanne: At the end of the initial 60-minute assessment
Participants' proposed treatment plans for primary care clinical cases will be evaluated using a predefined scoring rubric. Higher scores indicate better treatment planning performance.
At the end of the initial 60-minute assessment
Change in Overall Clinical Decision-Making Score After LLM Review
Tijdsspanne: Change from 60 to 90 minutes after the start of the assessment
Among participants assigned to the LLM second-opinion phase, the change in overall clinical decision-making score will be calculated as the score after LLM-assisted review minus the score before LLM-assisted review. Positive values indicate improvement in overall clinical decision-making performance.
Change from 60 to 90 minutes after the start of the assessment

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Peking University Third Hospital

Medewerkers

Xinjiang Second Medical College

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 juli 2026

Primaire voltooiing (Geschat)

1 augustus 2026

Studie voltooiing (Geschat)

1 september 2026

Studieregistratiedata

Eerst ingediend

14 juli 2026

Eerst ingediend dat voldeed aan de QC-criteria

14 juli 2026

Eerst geplaatst (Werkelijk)

17 juli 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

17 juli 2026

Laatste update ingediend die voldeed aan QC-criteria

14 juli 2026

Laatst geverifieerd

1 juli 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • IRB00006761-M20260614

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

Abonneren