AI-assisted Rare Disease Diagnosis
A Multicentre Randomised Controlled Trial of LLM-Assisted Diagnostic Support in Patients With Suspected Rare or Diagnostically Unresolved Disease
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Szczegółowy opis
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.
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Shuyang Zhang, MD, PhD
- Numer telefonu: +86-13911667211
- E-mail: shuyangzhang103@163.com
Lokalizacje studiów
-
-
-
Beijing, Chiny
- Peking Union Medical College Hospital
-
Kontakt:
- Shuyang Zhang
- Numer telefonu: +86-13911667211
- E-mail: shuyangzhang103@163.com
-
Cangzhou, Chiny
- Cangzhou Central Hospital
-
Kontakt:
- Yong Li
- Numer telefonu: +86-0317-2075013
- E-mail: czszxyyirb@163.com
-
Changchun, Chiny
- Changchun Sacred Heart Hospital
-
Dongguan, Chiny
- Dongguan People's Hospital
-
Foshan, Chiny
- First People's Hospital of Foshan
-
Guiyang, Chiny
- Guizhou Provincial People's Hospital
-
Jilin City, Chiny
- Jilin Central General Hospital
-
Kunming, Chiny
- The First People's Hospital of Yunnan Province
-
Tianjin, Chiny
- Tianjin Children's Hospital
-
Tianshui, Chiny
- Tianshui 407 Hospital
-
Kontakt:
- Rong Sun
- Numer telefonu: +86-0938-8229999
- E-mail: ts407yy@sina.com
-
Wuhai, Chiny
- Wuhai People's Hospital
-
Xining, Chiny
- Qinghai Provincial People's Hospital
-
Zhangzhou, Chiny
- Zhangzhou Municipal Hospital of Fujian Province
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dziecko
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
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.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Diagnostyczny
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Pojedynczy
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
|
Eksperymentalny: 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.
|
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.
|
|
Brak interwencji: 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.
|
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Overall Correct Diagnostic Yield
Ramy czasowe: 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.
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Physician-Reported Experience
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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.
|
Współpracownicy i badacze
Sponsor
Sponsor
Współpracownicy
Współpracownicy
Śledczy
Śledczy
- Główny śledczy: Shuyang Zhang, MD, PhD, Peking Union Medical College Hospital
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- PUMCH I-26PJ0002
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- SOK ROŚLINNY
- ANALITYCZNY_KOD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .