Prospective Assessment of Alignment Between Multimodal Artificial Intelligence and Multidisciplinary Team Decisions in Gastrointestinal Oncology
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Studietyp
Studietyp
Inskrivning (Beräknad)
Inskrivning
Kontakter och platser
Studiekontakt
Studiekontakt
- Namn: Jing Sun, MD, PhD
- Telefonnummer: +86-13524284622
- E-post: sj11788@rjh.com.cn
Studieorter
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Shanghai Municipality
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Shanghai, Shanghai Municipality, Kina, 200025
- Ruijin hospital Shanghai Jiaotong University, School of Medicine
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Kontakt:
- Jing Sun, MD, PhD
- Telefonnummer: +86-13524284622
- E-post: sj11788@rjh.com.cn
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-
Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Testmetod
Studera befolkning
Beskrivning
Inclusion Criteria:
- Aged 18 years or older, with no restriction based on sex.
- Histologically confirmed gastric, colon, or rectal cancer; or highly suspected gastric, colon, or rectal malignancy based on clinical, endoscopic, or imaging findings, with further diagnostic, staging, or treatment planning required.
- Scheduled for multidisciplinary team evaluation at the study center because of an initial diagnosis, clinical staging, perioperative treatment, surgical planning, recurrence or metastasis, conversion therapy, treatment response assessment, or another complex clinical management question.
- A clearly identifiable clinical decision time point can be established, and the clinical information available before that time point can be defined.
- At the clinical decision time point, at least the basic medical history, the clinical question to be addressed, and at least one core source of information from endoscopy, pathology, or imaging are available. Completion of all examinations is not required, because missing examinations may be evaluated as part of diagnostic task planning.
- A corresponding multidisciplinary team recommendation regarding diagnostic tasks or the principal treatment decision can be obtained for comparison with the artificial intelligence output.
- Willing and able to understand the study and provide dated written informed consent.
Exclusion Criteria:
- Further examination confirms a condition other than gastric, colon, or rectal cancer, and the case is not applicable to the gastrointestinal oncology pathways evaluated in this study.
- The participant is undergoing routine follow-up or continuation of a previously established treatment plan and has no clinical question requiring additional diagnostic tasks, modification of the principal treatment pathway, or multidisciplinary team decision-making.
- A clear clinical decision time point cannot be established, or information available before and after the decision cannot be distinguished, preventing comparison of the artificial intelligence system and the multidisciplinary team under the same information conditions.
- Core clinical information is severely incomplete, such that the current stage of care and the clinical question cannot be identified and a clinically meaningful artificial intelligence output cannot be generated.
- A clear multidisciplinary team recommendation corresponding to the clinical decision time point cannot be obtained, or the multidisciplinary team documentation is insufficient for paired evaluation.
- The participant requires immediate resuscitation or urgent clinical management, and study recruitment could interfere with necessary medical care.
- The participant is unable to provide valid informed consent because of impaired consciousness, severe cognitive impairment, or another reason, and no ethics-approved proxy consent procedure is available for this study.
- The participant declines research use of the medical record, endoscopic, pathological, imaging, or other required clinical data.
- Any other condition that, in the investigator's judgment, could seriously affect participant rights, data compliance, or the reliability of the study results.
Studieplan
Hur är studien utformad?
Designdetaljer
Antal grupper/kohorter
Kohorter och interventioner
Grupp / KohortGrupp / Kohort |
Intervention / BehandlingIntervention / Behandling |
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Patients With Gastrointestinal Tumors
Participants with gastric, colon, or rectal tumors who are prospectively enrolled and undergo parallel, independent clinical decision assessments by a multimodal artificial intelligence system and a multidisciplinary team using the same clinical information available at the predefined decision time point.
AI-generated recommendations are used solely for research evaluation and do not directly influence clinical care.
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Using the same clinical information available at the predefined decision time point, the institutional multidisciplinary team will independently formulate recommendations regarding diagnosis, staging, additional examinations, and treatment planning according to routine clinical practice.
Clinical management will remain under the responsibility of the treating physicians and the multidisciplinary team.
The MDT decision and the independently generated AI output will subsequently be compared and evaluated by an independent expert panel.
Available clinical information for each enrolled participant, including medical history, laboratory findings, endoscopic findings, imaging, pathology, and molecular testing results when available, will be entered into a multimodal artificial intelligence system.
The system will independently generate a structured assessment of diagnosis, staging, additional diagnostic tasks, and treatment planning.
The AI-generated output will be recorded solely for research comparison, will not be disclosed to the treating multidisciplinary team before its decision is finalized, and will not directly influence patient care.
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Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Clinical Acceptability Concordance Rate Between the Multimodal Artificial Intelligence System and the Multidisciplinary Team
Tidsram: At the predefined index clinical decision point, within 28 days after enrollment
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The proportion of evaluable participants whose AI-generated diagnostic task plan and principal treatment recommendation are judged by an independent expert panel to be fully concordant with the MDT decision or a clinically acceptable alternative.
Results will be reported as a percentage with a 95% confidence interval.
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At the predefined index clinical decision point, within 28 days after enrollment
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Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Full Concordance Rate
Tidsram: At the predefined index clinical decision point, within 28 days after enrollment
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The proportion of evaluable participants whose AI-generated diagnostic task plan and principal treatment recommendation are judged to be fully concordant with the MDT decision.
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At the predefined index clinical decision point, within 28 days after enrollment
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Major Discordance Rate
Tidsram: At the predefined index clinical decision point, within 28 days after enrollment
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The proportion of evaluable participants whose AI-generated recommendation is judged to contain a major discordance with potential for clinically significant harm.
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At the predefined index clinical decision point, within 28 days after enrollment
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Successful AI Output Rate
Tidsram: At the predefined index clinical decision point, within 28 days after enrollment
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The proportion of enrolled participants for whom the AI system successfully generates an evaluable diagnostic task plan and principal treatment recommendation.
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At the predefined index clinical decision point, within 28 days after enrollment
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Andra resultatmått
Andra resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Distribution of AI-MDT Discordance Types
Tidsram: At completion of independent expert evaluation, within 28 days after enrollment
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The number and percentage of discordant cases classified by type, including diagnostic or staging errors, inappropriate additional testing, treatment selection errors, treatment sequencing errors, and potential safety risks.
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At completion of independent expert evaluation, within 28 days after enrollment
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Samarbetspartners och utredare
Sponsor
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Studiestart
Primärt slutförande (Beräknad)
Primärt slutförande
Avslutad studie (Beräknad)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
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Nyckelord
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