Decision Support Systems, Clinical, Referral and Consultation
Conditions
Keywords
clinical decision support, electronic consultation, primary care, artificial intelligence
Brief summary
The goal of this study is to test an artificial intelligence (AI) tool called SAGE. SAGE helps primary care doctors with questions that often need a specialist. Primary care doctors are the doctors people usually see first. SAGE reviews a case and suggests what a specialist might advise. The main questions it aims to answer are: * Do doctors make sound, timely care decisions when they use SAGE? * Do those decisions match what a specialist would advise? Researchers will compare the decisions doctors make with and without SAGE. Doctors in the study will: * Review made-up patient cases (these are not real patients) * Make a decision for each case, their usual way and with SAGE
Interventions
OTHERSAGE (AI clinical decision support)
SAGE is an artificial intelligence (AI) based clinical decision support tool. It generates specialty-informed recommendations for a primary care consultation question. Physicians review the SAGE output while making a management decision for the synthetic case.
OTHERStandard eConsult
A standard electronic consultation (eConsult) format, without SAGE. Physicians review this information while making a management decision for the synthetic case.
Sponsors
Stanford University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Physician practicing in primary care internal medicine and/or family medicine * Attending physician, or resident physician at postgraduate year 2 (PGY-2) or higher * Stanford-affiliated (faculty, staff, or trainee) * Able to complete a single, approximately 60-minute remote (Zoom) session conducted in English
Exclusion criteria
* Not currently practicing in primary care internal medicine or family medicine * Member of the study team or otherwise involved in the development of SAGE * Unable to complete the remote study session
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical actionability of the clinician's decision | Post-session independent review, through study completion (up to approximately 2 months) | For each case, independent reviewers judge whether the physician's decision is clinically actionable, meaning the physician can act on it now rather than wait for a specialist. The outcome is the proportion of cases judged actionable, measured separately for decisions made with SAGE and for decisions made the standard way. |
| Concordance of the clinician's decision with the specialist reference answer | Post-session independent review, through study completion (up to approximately 2 months) | Agreement between the physician's management decision and a specialist reference answer, rated by independent reviewers, with inter-rater agreement summarized. Assessed for decisions made with SAGE and for decisions made the standard way. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| System usability (System Usability Scale, SUS) | End of study session (Day 1, approximately 60 minutes) | Perceived usability of SAGE measured with the 10-item System Usability Scale (SUS), scored from 0 to 100. |
| Order acceptance in the SAGE condition | During study session (Day 1) | Proportion of SAGE-suggested orders that the clinician accepts, assessed in the SAGE condition. |
| Time to complete case review | During study session (Day 1) | Time (in minutes) taken to review each case and reach a management decision, compared between the SAGE and standard eConsult conditions. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORJonathan Chen, MD, PhD
Stanford University
Outcome results
None listed