Preliminary Evaluation of a Large Language Model-Based Tool for Complex Surgical Decision Support in Lung Cancer
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Lokalizacje studiów
-
-
Beijing Municipality
-
Beijing, Beijing Municipality, Chiny, 100044
- Peking University People's Hospital
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
Resident Physician Subjects:
- Holds a valid and legally effective Physician Practice License of the People's Republic of China;
- Currently holds the rank of resident physician in a thoracic surgery department at a tertiary Class A (3A) hospital;
- Agrees to complete all assessment tasks of the main study phase in accordance with the study protocol;
- Can guarantee the time and effort required to complete all assessment tasks of the main study.
Study Cases:
- The case was discussed at the Thoracic Oncology Multidisciplinary Team (MDT) conference of Peking University People's Hospital between January 2025 and May 2026;
- The current version of the NCCN guidelines does not provide an explicit recommendation covering the management of the case;
- Does not overlap with the GAPS evaluation set;
- The case is presented in pure text in a structured format, with all direct and indirect identifiers removed and complete de-identification performed prior to inclusion;
- From the pool of eligible cases, 12 cases will be randomly drawn using Python (numpy.random, with a fixed and archived seed) to serve as the main study cases. The cases will cover 6 themes (chest mass of undetermined diagnosis, early-stage lung cancer, locally advanced lung cancer, oligometastatic/oligoprogressive disease, special intraoperative situations, and tumor recurrence), with 2 cases per theme.
Adjudication Expert Panel:
- Holds a valid and legally effective Physician Practice License of the People's Republic of China;
- Currently holds the rank of attending physician or above in a thoracic surgery department at a tertiary Class A hospital;
- Chairs or regularly participates in lung cancer multidisciplinary team (MDT) work in their department.
Exclusion Criteria:
Resident Physician Subjects:
- Has previously participated in the construction of the GAPS evaluation set or the development of GAPS-Agent;
- Unable to complete the tasks of the study phase.
Study Cases:
- Key case information is missing, such as text-form data on pathology (including IHC/NGS), imaging, laboratory tests, prior medical history, comorbidities, or PS score;
- Decision-making for the case is strictly dependent on non-text information.
Adjudication Expert Panel:
- Participated in the construction of the GAPS evaluation set, the content validity verification, or the development of GAPS-Agent for this study;
- Has a direct conflict of interest with any specific product among the two-arm tools of this study.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Inny
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Pojedynczy
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
|
Eksperymentalny: test arm
GAPS-Agent
|
The research group has previously developed the GAPS evaluation framework for complex clinical decision-making in lung cancer.
In this framework, G (Grounding) characterizes the cognitive depth of decision-making (ranging from knowledge retrieval to decisions that go beyond clinical guidelines), A (Authority) corresponds to the grading of evidence strength, P (Perturbation) describes the identification and management of real-world clinical confounding factors, and S (Strength) corresponds to the calibration of recommendation strength.
Within this framework, the research group has completed the construction of a 100-item complex lung cancer decision-making evaluation set along with its corresponding rubrics, and has invited multiple thoracic oncology experts to complete content validity validation.
Based on this, the research group developed GAPS-Agent, which uses an open-source large language model as its foundation and integrates functional modules such as guideline and evidence retri
|
|
Aktywny komparator: control arm
LLM
|
Open source large language model that is not specifically enhanced in medical field.
|
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Overall plan Win Ratio
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
A total of 10 blinded expert judges made Win/Tie/Loss ternary preference judgments on 192 paired scheme comparisons in terms of overall scheme quality.
The win ratio was calculated as Wins ÷ Losses, and the 95% confidence interval was estimated using a two-level (physician × case) cluster bootstrap resampling method (B = 10,000, quantile method on the log scale).
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Inter-rater agreement
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
For the ternary preference judgment results of 10 expert judges across 192 paired comparisons and 6 evaluation domains, Fleiss' kappa was used to assess inter-rater agreement.
The kappa value and its 95% confidence interval are reported for each evaluation domain.
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
|
Redundancy Win Ratio
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
A total of 10 blinded expert judges made Win/Tie/Loss ternary preference judgments on 192 paired scheme comparisons in terms of overall scheme quality.
The win ratio was calculated as Wins ÷ Losses, and the 95% confidence interval was estimated using a two-level (physician × case) cluster bootstrap resampling method (B = 10,000, quantile method on the log scale).
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
|
Evidence-based medicine adherence Win Ratio
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
A total of 10 blinded expert judges made Win/Tie/Loss ternary preference judgments on 192 paired scheme comparisons in terms of overall scheme quality.
The win ratio was calculated as Wins ÷ Losses, and the 95% confidence interval was estimated using a two-level (physician × case) cluster bootstrap resampling method (B = 10,000, quantile method on the log scale).
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
|
Actionability Win Ratio
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
A total of 10 blinded expert judges made Win/Tie/Loss ternary preference judgments on 192 paired scheme comparisons in terms of overall scheme quality.
The win ratio was calculated as Wins ÷ Losses, and the 95% confidence interval was estimated using a two-level (physician × case) cluster bootstrap resampling method (B = 10,000, quantile method on the log scale).
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
|
Completeness Win Ratio
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
A total of 10 blinded expert judges made Win/Tie/Loss ternary preference judgments on 192 paired scheme comparisons in terms of overall scheme quality.
The win ratio was calculated as Wins ÷ Losses, and the 95% confidence interval was estimated using a two-level (physician × case) cluster bootstrap resampling method (B = 10,000, quantile method on the log scale).
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
|
Safety Win Ratio
Ramy czasowe: Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
A total of 10 blinded expert judges made Win/Tie/Loss ternary preference judgments on 192 paired scheme comparisons in terms of overall scheme quality.
The win ratio was calculated as Wins ÷ Losses, and the 95% confidence interval was estimated using a two-level (physician × case) cluster bootstrap resampling method (B = 10,000, quantile method on the log scale).
|
Measured at the time when experts completed their preference judgements. Calculated up to 3 weeks after the preference judgements.
|
|
GAPS automated rubric score
Ramy czasowe: Generated up to 3 weeks after residents finished their plan generation.
|
A third-party large language model, independent of the two study arms' base models, served as the judge model and automatically scored all 96 plans according to the GAPS rubric.
|
Generated up to 3 weeks after residents finished their plan generation.
|
|
Subject physician's self-confidence score
Ramy czasowe: Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
After submitting each case plan, the participating physicians self-rated their confidence in their own plan using a 1-5 point Likert scale.
|
Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
|
Tool satisfaction score
Ramy czasowe: Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
After submitting each case plan, the participating physicians rated their satisfaction with the tool using a 1-5 point Likert scale.
|
Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
|
Tool trustworthiness score
Ramy czasowe: Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
After submitting each case plan, the participating physicians rated the tool's credibility using a 1-5 point Likert scale.
|
Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
|
Decision-making time
Ramy czasowe: Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
The time taken (in minutes) by each participating physician to complete the production of each case plan was automatically recorded by the evaluation platform.
Differences between groups were analyzed using a linear mixed-effects model.
|
Completed at the time when residents submitted their plans. Calculated up to 3 weeks after the submission.
|
Współpracownicy i badacze
Sponsor
Sponsor
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
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
- 2026PHB458-001
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
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 .
Badania kliniczne na Rak płuc (NSCLC)
-
NCT07126561Jeszcze nie rekrutacjaHER2 Pozytywne nowo zdiagnozowane przerzuty przełyku, żołądka, GEJ Cancer Pacjenci ze statusem wydajności ECOG 2
-
NCT07612722Rekrutacyjny
-
NCT07376382Jeszcze nie rekrutacja
-
NCT07281209Jeszcze nie rekrutacja
-
NCT06218069Jeszcze nie rekrutacja
-
NCT07530276Aktywny, nie rekrutujący
-
NCT06255951Zakończony
Badania kliniczne na GAPS-Agent
-
NCT07038343RekrutacyjnyRak guza litego | Rak urotelialny | Guzy lite z przerzutami | Rak dróg żółciowych (BTC) | Raki płuc | Zaawansowane lokalnie | Guz nabłonkowy | Nowotwory jamy nosowo-gardłowej
-
NCT03623971ZakończonyZaćma | Sztuczna inteligencja
-
NCT07193511RekrutacyjnyRak guza litego | Rak urotelialny | Guzy lite z przerzutami | Zaawansowane lokalnie
-
NCT07014137Rekrutacyjny
-
NCT06435819Rekrutacyjny
-
NCT04156841NieznanyRak piersi | Wartowniczy węzeł chłonny
-
NCT04582201ZakończonyZespół zaburzeń oddychania, dorosły
-
NCT05168748WycofaneOstra białaczka limfoblastyczna