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AI-Augmented Diagnostic Assessment With ENLIGHT Versus Independent Pathologist Review (ENLIGHT)

28 lipca 2026 zaktualizowane przez: Kun-Hsing Yu, Harvard Medical School (HMS and HSDM)

This study will evaluate whether artificial intelligence (AI) can enhance clinicians' accuracy, efficiency, and confidence in distinguishing lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC) and kidney renal papillary cell carcinoma (KIRP) from kidney renal clear cell carcinoma (KIRC) using digitized pathology slides. These subtype classifications are routinely performed by pathologists but can be challenging and time-consuming, particularly in difficult cases.

During the study, participating clinicians will review lung and kidney pathology slides under three different conditions:

  • Unaided Review: Diagnosis without AI assistance.
  • AI as Double-Check: The clinician first makes an independent diagnosis, after which the AI-generated diagnosis (prediction only or prediction with explanation) is revealed for review.
  • AI as First-Look: The AI-generated diagnosis (prediction only or prediction with explanation) is presented before the clinician begins the review.

Clinicians will be randomly assigned to different review sequences to minimize potential order effects. This study design will enable us to assess the impact of AI assistance on diagnostic accuracy, interpretation time, and clinician confidence.

Przegląd badań

Status

Rejestracja na zaproszenie

Warunki

Interwencja / Leczenie

Szczegółowy opis

This study aims to evaluate the effect of artificial intelligence (AI) assistance on clinicians' diagnostic performance in distinguishing lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC) and kidney renal papillary cell carcinoma (KIRP) from kidney renal clear cell carcinoma (KIRC) using digitized hematoxylin and eosin (H&E)-stained whole-slide images (WSIs). ENLIGHT (Explainable Neoplasm Learning In Grounded Histology Terms) will serve as the AI system under evaluation. This is a single-session, within-reader, between-case study in which each reader evaluates distinct sets of cases under all study conditions.

The study includes three diagnostic blocks: Block X, in which WSIs are reviewed without AI assistance; Block Y1, in which clinicians make an initial diagnosis before viewing the AI output as a double-check; and Block Y2, in which the AI output is displayed before clinicians begin their review as a first-look aid. Within each AI-assisted block, the prediction-only and prediction-with-explanation sub-blocks are presented in randomized order.

Each participating pathologist will review up to 400 de-identified WSIs (up to 200 lung cancer and up to 200 kidney cancer cases). Readers will be randomly assigned to one of four study arms that differ only in the order in which Blocks X, Y1, and Y2 are completed. For each reader, distinct WSIs will be randomly assigned to the diagnostic conditions so that no WSI is reviewed more than once by the same reader.

  • Arm 1 (X -> Y1 -> Y2): Clinicians first complete Block X (Unaided Review), followed by Block Y1 (AI as Double-Check) and then Block Y2 (AI as First-Look).
  • Arm 2 (X -> Y2 -> Y1): Clinicians first complete Block X (Unaided Review), followed by Block Y2 (AI as First-Look) and then Block Y1 (AI as Double-Check).
  • Arm 3 (Y1 -> Y2 -> X): Clinicians first complete Block Y1 (AI as Double-Check), followed by Block Y2 (AI as First-Look), and then Block X (Unaided Review).
  • Arm 4 (Y2 -> Y1 -> X): Clinicians first complete Block Y2 (AI as First-Look), followed by Block Y1 (AI as Double-Check), and then Block X (Unaided Review).

For each case, diagnostic accuracy, time to diagnosis, and diagnostic confidence will be recorded. No reader will review the same WSI under more than one condition, thereby eliminating within-reader recall bias. In parallel, the ENLIGHT model will independently generate diagnostic predictions for all WSIs to enable direct benchmarking of AI performance against pathologists and to evaluate the impact of different AI-assisted workflows on diagnostic performance.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

25

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

    • Massachusetts
      • Boston, Massachusetts, Stany Zjednoczone, 02115
        • Harvard Medical School,

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dziecko
  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria for Pathology Slides (i.e., Cases):

  • Hematoxylin and eosin (H&E)-stained pathology slides
  • Final diagnosis confirmed through molecular testing in conjunction with expert pathology evaluation

Exclusion Criteria for Pathology Slides (i.e., Cases):

  • Poor-quality or unreadable slides
  • Cases used in AI training

Inclusion Criteria for Readers (i.e., Participants):

  • Board-certified or board-eligible pathologists
  • Willingness to complete both unaided and AI-assisted review sessions

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Diagnostyczny
  • Przydział: Randomizowane
  • Model interwencyjny: Zadanie krzyżowe
  • Maskowanie: Poczwórny

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Aktywny komparator: Unaided Review First, Then AI as Double-Check, Then AI as First-Look.
Readers first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Readers first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.
Aktywny komparator: Unaided Review First, Then AI as First-Look, Then AI as Double-Check.
Readers first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Readers first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.
Aktywny komparator: AI as Double-Check Review First, Then AI as First-Look, Then Unaided Review.
Readers first complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Readers first complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.
Aktywny komparator: AI as First-Look Review First, Then AI as Double-Check, Then Unaided Review.
Readers first complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Readers first complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Diagnostic performance of cancers
Ramy czasowe: Periprocedural (at the time of slide review)
Performance of clinicians (unaided and AI-assisted) for distinguishing LUAD- LUSC and distinguishing KIRP-KIRC, measured in accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1.
Periprocedural (at the time of slide review)

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Czas na diagnozę
Ramy czasowe: Periprocedural (w czasie przeglądu slajdów)
Średni czas (sekundy na przypadek) wymagany do sfinalizowania diagnozy.
Periprocedural (w czasie przeglądu slajdów)
Zmienność między obserwatorem
Ramy czasowe: Periprocedural (w czasie przeglądu slajdów)
Zgoda klinicystów w różnych warunkach, mierzona za pomocą wskaźników niezawodności między oceniają (np. Statystyka Kappa).
Periprocedural (w czasie przeglądu slajdów)
Świadczenie netto po ekspozycji AI
Ramy czasowe: Periprocedural (w czasie przeglądu slajdów)
Ogólna zmiana dokładności diagnostycznej przypisywanej pomocy AI.
Periprocedural (w czasie przeglądu slajdów)
Clinician confidence level
Ramy czasowe: Periprocedural (at the time of slide review)
Self-reported diagnostic confidence recorded for each case. Scale: 5 - Absolutely Certain; 4 - Mostly Certain; 3 - Unsure; 2 - Very Doubtful; 1 - Random Guess; With 5 being the highest confidence score and 1 being the lowest.
Periprocedural (at the time of slide review)

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 lipca 2026

Zakończenie podstawowe (Szacowany)

1 sierpnia 2026

Ukończenie studiów (Szacowany)

1 sierpnia 2026

Daty rejestracji na studia

Pierwszy przesłany

28 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

28 lipca 2026

Pierwszy wysłany (Rzeczywisty)

3 sierpnia 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

3 sierpnia 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

28 lipca 2026

Ostatnia weryfikacja

1 lipca 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • ENLIGHT Study

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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 .