Gastrointestinal Hemorrhage
Conditions
Keywords
Implementation science, Artificial intelligence, Decision Support Systems, Clinical, Simulation Training
Brief summary
The purpose of this research study is to measure the effect on of a large language model interface on the usability, attitudes, and provider trust when using a machine learning algorithm-based clinical decision support system in the setting of bleeding from the upper gastrointestinal tract (upper GIB). Specifically, the investigators are looking to assess the optimal implementation of such machine learning algorithms in simulation scenarios to best engender trust and improve usability. Participants will be randomized to either machine learning algorithm alone or algorithm with a large language model interface and exposed to simulation cases of upper GIB.
Detailed description
The experiment will deploy a previously validated machine learning algorithm trained on existing clinical datasets within simulation scenarios in which a patient with acute gastrointestinal bleeding (at low, moderate, and high risk for poor outcome) is evaluated. Prior to the simulation, a baseline educational module about artificial intelligence, machine learning, and clinical decision support will be provided to all participants. The investigators will establish psychological safety by detailing what is available in the room, the opportunity to call a consultant, and availability of laboratory and radiographic studies. Each clinical scenario will run for approximately 10 minutes based on real patient cases where vital signs change over time and laboratory values are made available at specific points in the assessment. The study will evaluate the effect of a large language model-based interaction with the machine learning algorithm with interpretability dashboard compared to the machine learning algorithm with interpretability dashboard alone. Each participant will receive three scenarios in randomized order of risk. For the large language model interaction arm, participants will be provided the computer workstation a LLM chatbot interface of the algorithm and interpretability dashboard For the machine learning dashboard arm, participants will be provided the computer workstation with the algorithm and interpretability dashboard.
Interventions
Use of a Large Language Model (LLM) chatbot interface to Interact with the Machine Learning Algorithm and interpretability dashboard.
Sponsors
Study design
Eligibility
Inclusion criteria
* Internal Medicine residency trainees at study institution * Emergency Medicine residency trainees at study institution
Exclusion criteria
* N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Median Change in Attitudes Towards Machine Learning Algorithms in Clinical Care Using UTAUT | Approximately 60 minutes | The study will use a common set of dependent variables to assess baseline and post-intervention attitudes towards machine learning algorithms in clinical care using an adapted Unified Theory of Acceptance and Use of Technology (UTAUT) survey assessing perceived usefulness of the system, perceived ease of use, attitudes towards using it, behavioral intentions, and trust, measured with a 5-point Likert scale. Percent change in UTAUT survey response between Large Language Model-based Interaction and Machine Learning Dashboard at recruitment prior to administration of scenarios and immediately after completion of scenarios. The difference in time between the two will be approximately 60 minutes. Higher change indicates greater acceptance/intention to use the GutGPT+Dashboard. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinician Decision Making of Triage of GI Bleeding | Approximately 60 minutes | Mean percentage of decision accuracy per participant. Accuracy is defined as the percentage of times participants accurately choose the correct clinical decision for each simulation scenario of acute upper GI bleeding for each treatment condition. Immediately after completion of scenarios (60 minutes from initiation of study for each participant). No further follow up afterwards. |
Countries
United States
Contacts
Yale School of Medicine Section of Digestive Diseases
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Customized 18 - 24 years | 2 Participants |
| Age, Customized 25-29 years | 60 Participants |
| Age, Customized 30-34 years | 31 Participants |
| Age, Customized 35-39 years | 10 Participants |
| Age, Customized 40-44 years | 2 Participants |
| Age, Customized 45-49 years | 1 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Familiarity with Artificial Intelligence (AI) Not at all or slightly | 83 Participants |
| Familiarity with Artificial Intelligence (AI) Some AI Coursework | 3 Participants |
| Familiarity with Artificial Intelligence (AI) Unknown/Did not answer | 9 Participants |
| Mean baseline Unified Theory of Acceptance and Use of Technology (UTAUT) survey score Behavioral Intention | 3.4 score on a scale STANDARD_DEVIATION 0.1 |
| Mean baseline Unified Theory of Acceptance and Use of Technology (UTAUT) survey score Effort Expectancy | 3.0 score on a scale STANDARD_DEVIATION 0.1 |
| Mean baseline Unified Theory of Acceptance and Use of Technology (UTAUT) survey score Facilitating Conditions | 2.7 score on a scale STANDARD_DEVIATION 0.1 |
| Mean baseline Unified Theory of Acceptance and Use of Technology (UTAUT) survey score Performance Expectancy | 3.4 score on a scale STANDARD_DEVIATION 0.1 |
| Mean baseline Unified Theory of Acceptance and Use of Technology (UTAUT) survey score Social Influence | 3.4 score on a scale STANDARD_DEVIATION 0.1 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 24 Participants |
| Race (NIH/OMB) Black or African American | 7 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 4 Participants |
| Race (NIH/OMB) White | 26 Participants |
| Sex: Female, Male Female | 6 Participants |
| Sex: Female, Male Male | 48 Participants |
| Training level Medical Student | 25 Participants |
| Training level Residency | 41 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 52 | 0 / 56 |
| other Total, other adverse events | 0 / 52 | 0 / 56 |
| serious Total, serious adverse events | 0 / 52 | 0 / 56 |