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AI-assisted Rare Disease Diagnosis

30. juli 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

1056

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Diagnostisk
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Annen: 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.
Ingen inngripen: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Overall Correct Diagnostic Yield
Tidsramme: 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.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Physician-Reported Experience
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Peking Union Medical College Hospital

Samarbeidspartnere

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

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. august 2026

Primær fullføring (Antatt)

1. juli 2027

Studiet fullført (Antatt)

1. desember 2027

Datoer for studieregistrering

Først innsendt

7. juni 2026

Først innsendt som oppfylte QC-kriteriene

14. juni 2026

Først lagt ut (Faktiske)

16. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

31. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. juli 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • PUMCH I-26PJ0002

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

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

IPD-delingstidsramme

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

Tilgangskriterier for IPD-deling

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.

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL
  • SEVJE
  • ANALYTIC_CODE

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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