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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:
Researchers will compare the decisions doctors make with and without SAGE.
Doctors in the study will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primary care physicians | Experimental | Primary care physicians make management decisions on synthetic patient cases. Each physician reviews four cases in random order: two with SAGE (AI clinical decision support) and two using a standard eConsult approach. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SAGE (AI clinical decision support) | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical actionability of the clinician's decision | 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. | Post-session independent review, through study completion (up to approximately 2 months) |
| Concordance of the clinician's decision with the specialist reference answer | 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. | Post-session independent review, through study completion (up to approximately 2 months) |
| Measure | Description | Time Frame |
|---|---|---|
| System usability (System Usability Scale, SUS) | Perceived usability of SAGE measured with the 10-item System Usability Scale (SUS), scored from 0 to 100. | End of study session (Day 1, approximately 60 minutes) |
| Order acceptance in the SAGE condition |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jonathan Chen, MD, PhD | Stanford University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University | Stanford | California | 94305 | United States |
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|
| Standard eConsult | Other | A standard electronic consultation (eConsult) format, without SAGE. Physicians review this information while making a management decision for the synthetic case. |
|
Proportion of SAGE-suggested orders that the clinician accepts, assessed in the SAGE condition.
| During study session (Day 1) |
| Time to complete case review | Time (in minutes) taken to review each case and reach a management decision, compared between the SAGE and standard eConsult conditions. | During study session (Day 1) |