Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Rheumatol Int. 2022 Dec;42(12):2167-2176. doi: 10.1007/s00296-022-05202-4. Epub 2022 Sep 10.
Symptom checkers are increasingly used to assess new symptoms and navigate the health care system. The aim of this study was to compare the accuracy of an artificial intelligence (AI)-based symptom checker (Ada) and physicians regarding the presence/absence of an inflammatory rheumatic disease (IRD). In this survey study, German-speaking physicians with prior rheumatology working experience were asked to determine IRD presence/absence and suggest diagnoses for 20 different real-world patient vignettes, which included only basic health and symptom-related medical history. IRD detection rate and suggested diagnoses of participants and Ada were compared to the gold standard, the final rheumatologists' diagnosis, reported on the discharge summary report. A total of 132 vignettes were completed by 33 physicians (mean rheumatology working experience 8.8 (SD 7.1) years). Ada's diagnostic accuracy (IRD) was significantly higher compared to physicians (70 vs 54%, p = 0.002) according to top diagnosis. Ada listed the correct diagnosis more often compared to physicians (54 vs 32%, p < 0.001) as top diagnosis as well as among the top 3 diagnoses (59 vs 42%, p < 0.001). Work experience was not related to suggesting the correct diagnosis or IRD status. Confined to basic health and symptom-related medical history, the diagnostic accuracy of physicians was lower compared to an AI-based symptom checker. These results highlight the potential of using symptom checkers early during the patient journey and importance of access to complete and sufficient patient information to establish a correct diagnosis.
症状检查器越来越多地被用于评估新出现的症状并在医疗保健系统中进行导航。本研究的目的是比较基于人工智能（AI）的症状检查器（Ada）和医生在评估炎症性风湿病（IRD）的存在/缺失方面的准确性。在这项调查研究中，要求具有先前风湿病工作经验的德语医生确定 IRD 的存在/缺失，并为 20 个不同的真实患者案例提出诊断，这些案例仅包含基本的健康和与症状相关的病史。将参与者和 Ada 的 IRD 检测率和建议的诊断与金标准（最终风湿病医生的诊断）进行比较，金标准是在出院总结报告中报告的。共有 33 名医生完成了 132 个案例（平均风湿病工作经验为 8.8（SD 7.1）年）。Ada 的诊断准确性（IRD）明显高于医生（70%对 54%，p=0.002），根据主要诊断。Ada 作为主要诊断和前 3 个诊断（59%对 42%，p<0.001）比医生更常列出正确的诊断（54%对 32%，p<0.001）。工作经验与提出正确诊断或 IRD 状态无关。仅考虑基本健康和与症状相关的病史，医生的诊断准确性低于基于 AI 的症状检查器。这些结果强调了在患者就诊早期使用症状检查器的潜力，以及获得完整和充分的患者信息以建立正确诊断的重要性。
