Department of General Internal Medicine, Nagano Chuo Hospital, Nagano 380-0814, Japan.
Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi 321-0293, Japan.
Int J Environ Res Public Health. 2021 May 23;18(11):5562. doi: 10.3390/ijerph18115562.
A diagnostic decision support system (DDSS) is expected to reduce diagnostic errors. However, its effect on physicians' diagnostic decisions remains unclear. Our study aimed to assess the prevalence of diagnoses from artificial intelligence (AI) in physicians' differential diagnoses when using AI-driven DDSS that generates a differential diagnosis from the information entered by the patient before the clinical encounter on physicians' differential diagnoses. In this randomized controlled study, an exploratory analysis was performed. Twenty-two physicians were required to generate up to three differential diagnoses per case by reading 16 clinical vignettes. The participants were divided into two groups, an intervention group, and a control group, with and without a differential diagnosis list of AI, respectively. The prevalence of physician diagnosis identical with the differential diagnosis of AI (primary outcome) was significantly higher in the intervention group than in the control group (70.2% vs. 55.1%, < 0.001). The primary outcome was significantly >10% higher in the intervention group than in the control group, except for attending physicians, and physicians who did not trust AI. This study suggests that at least 15% of physicians' differential diagnoses were affected by the differential diagnosis list in the AI-driven DDSS.
诊断决策支持系统（DDSS）有望减少诊断错误。然而，其对医生诊断决策的影响尚不清楚。我们的研究旨在评估在临床就诊前，根据患者输入的信息，通过人工智能驱动的 DDSS 生成鉴别诊断，然后评估 AI 诊断出的诊断在医生鉴别诊断中的出现频率。在这项随机对照研究中，进行了探索性分析。要求 22 名医生阅读 16 个临床病例摘要，每个病例生成不超过 3 个鉴别诊断。参与者分为两组，干预组和对照组，分别有无 AI 生成的鉴别诊断列表。干预组医生与 AI 鉴别诊断相同的诊断（主要结局）的出现频率明显高于对照组（70.2% vs. 55.1%，<0.001）。除了主治医生和不信任 AI 的医生，干预组的主要结局明显比对照组高 10%以上。本研究表明，至少有 15%的医生的鉴别诊断受到了 AI 驱动的 DDSS 中鉴别诊断列表的影响。
