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AI Assisted Reader Evaluation in Acute Computed Tomography (CT) Head Interpretation

Active, not recruiting
Conditions
Intracranial Hemorrhages
Cerebral Edema
Hydrocephalus
Cerebral Injury
Acute Ischemic Stroke
Cerebral Infarction
Interventions
Other: Ground truthing
Other: Reading
Registration Number
NCT06018545
Lead Sponsor
Oxford University Hospitals NHS Trust
Brief Summary

This study has been added as a sub study to the Simulation Training for Emergency Department Imaging 2 study (ClinicalTrials.gov ID NCT05427838).

The purpose of the study is to assess the impact of an Artificial Intelligence (AI) tool called qER 2.0 EU on the performance of readers, including general radiologists, emergency medicine clinicians, and radiographers, in interpreting non-contrast CT head scans. The study aims to evaluate the changes in accuracy, review time, and diagnostic confidence when using the AI tool. It also seeks to provide evidence on the diagnostic performance of the AI tool and its potential to improve efficiency and patient care in the context of the National Health Service (NHS). The study will use a dataset of 150 CT head scans, including both control cases and abnormal cases with specific abnormalities. The results of this study will inform larger follow-up studies in real-life Emergency Department (ED) settings.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
33
Inclusion Criteria
  • Radiologists/Radiographers/ED clinicians who review CT head scans as part of their clinical practice
Exclusion Criteria
  • Neuroradiologists.
  • Non-radiologist groups: Clinicians with previous formal postgraduate CT reporting training
  • Emergency Medicine group: Clinicians with previous career in radiology/neurosurgery to registrar level

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Ground truthersGround truthingTwo Consultant neuroradiologists will independently review the images to establish the 'ground truth' findings on the CT scans which will be used as the reference standard. In the case of disagreement, a third senior neuroradiologist's opinion will be sought for arbitration. A difficulty score will be assigned to each scan by the ground truthers using a 5-point Likert scale.
ReadersReading30 readers will be recruited across four NHS trusts including ten general radiologists, fifteen emergency medicine clinicians, and five CT radiographers of varying seniority. Readers will interpret each scan first without, then with, the assistance of the AI tool, with an intervening 4-week washout period. Using a panel of neuroradiologists as ground truth, the stand-alone performance of qER will be assessed, and its impact on the readers' performance will be analysed as change in accuracy, mean review time per scan, and self-reported diagnostic confidence. Subgroup analyses will be performed by reader professional group, reader seniority, pathological finding, and neuroradiologist-rated difficulty.
Primary Outcome Measures
NameTimeMethod
Reader performance: Positive and negative predictive value, comparative between with and without AI assistance.During 6 weeks, which is the period for reading or reviewing the cases/scans.

Reader performance will be evaluated as Positive Predictive Value (PPV) and negative predictive value (NPV), with and without AI assistance.

qER (AI algorithm) performance: Positive and negative predictive value.During 6 weeks, which is the period for reading or reviewing the cases/scans.

qER performance will be evaluated as Positive Predictive Value (PPV) and negative predictive value (NPV).

Reader performance: Sensitivity, specificity, comparative between with and without AI assistance.During 6 weeks, which is the period for reading or reviewing the cases/scans.

Reader performance will be evaluated as sensitivity, specificity, with and without AI assistance.

Reader speed: Mean time taken to review a scan, with versus without AI assistance.During 6 weeks, which is the period for reading or reviewing the cases/scans.

Reader speed will be evaluated as the man time taken to review a scan, using time unite of seconds.

Reader confidence: Self-reported diagnostic confidence on a 10 point visual analogue scale, with vs without AI assistance.During 6 weeks, which is the period for reading or reviewing the cases/scans.

On the reading platform (RAIQC), one of the questions asks the level of confidence that the participant has in their diagnostic opinion. The question offers a scale of 1 to 10, where 1 is not confident, and 10 is highly confident.

qER (AI algorithm) performance: Sensitivity and specificityDuring 6 weeks, which is the period for reading or reviewing the cases/scans.

qER performance will be evaluated as sensitivity, specificity.

Reader performance: Area Under Receiver Operating Characteristic Curve (AUROC), comparative between with and without AI assistance.During 6 weeks, which is the period for reading or reviewing the cases/scans.

Reader performance will be evaluated as Area Under Receiver Operating Characteristic Curve (AUROC), with and without AI assistance.

qER (AI algorithm) performance: Area Under Receiver Operating Characteristic Curve (AUROC).During 6 weeks, which is the period for reading or reviewing the cases/scans.

qER performance will be evaluated as Area Under Receiver Operating Characteristic Curve (AUROC)

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (4)

NHS Greater Glasgow and Clyde

🇬🇧

Glasgow, United Kingdom

Oxford University Hospitals NHS Foundation Trust

🇬🇧

Oxford, Oxfordshire, United Kingdom

Guy's & St Thomas NHS Foundation Trust

🇬🇧

London, United Kingdom

Northumbria Healthcare NHS Foundation Trust

🇬🇧

Newcastle Upon Tyne, United Kingdom

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