This randomized crossover clinical trial will evaluate whether an artificial intelligence-based expert system improves the interpretation of chest radiographs by final-year medical students, rural physicians, and general practitioners with less than two years of clinical experience.
Participants will interpret chest radiographs containing normal findings or pulmonary opacities classified as alveolar, interstitial, or mixed. Each participant will review the same set of radiographs twice: once without assistance from the expert system and once with assistance from the artificial intelligence system. The order of these two reading conditions will be randomly assigned, with a six-week interval between sessions to reduce memory effects.
The main outcome will be the proportion of correct interpretations compared with a previously established reference standard based on radiologist interpretation supported by chest computed tomography findings. The study will also assess diagnostic confidence and agreement with the reference standard.
This study does not involve treatment decisions or direct patient care. It is intended to determine whether artificial intelligence support may improve the accuracy and confidence of less-experienced physicians when interpreting pulmonary opacities on chest radiographs.
Inclusion Criteria:
Exclusion Criteria:
Reading condition without expert-system assistance (Phase A). Participants interpret the assigned set of chest radiographs on a calibrated workstation using their own judgement only, with no output from the artificial intelligence expert system and without access to clinical information or chest computed tomography findings. For each image, participants record whether a pulmonary opacity is present, classify the pattern as alveolar, interstitial or mixed, and rate their diagnostic confidence on a 5-point Likert scale.
Reading condition with expert-system assistance (Phase B). Participants interpret the same set of chest radiographs on the same calibrated workstation, with the output of the artificial intelligence expert system displayed together with each image. For each image, participants record whether a pulmonary opacity is present, classify the pattern as alveolar, interstitial or mixed, and rate their diagnostic confidence on a 5-point Likert scale. Participants remain responsible for the final interpretation.
ChÃa, Cundinamarca 111321, Colombia
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