Respiratory Tract Infections (RTI)NCT07401979
The Influence of Explainability and Integrability of AI-CDSS on Usage Behavior Among Primary Care Physicians
A study testing AI-CDSS with Stepwise Medication and Auto-extraction, AI-CDSS with Feature Importance and Auto-extraction and AI-CDSS with Feature Importance and Stepwise Medication in people with Respiratory Tract Infections (RTI), run by Huazhong University of Science and Technology at 1 site in China.
Trial summary
The goal of this observational experimental study is to determine how system-level features of artificial intelligence clinical decision support systems (AI-CDSS)-specifically explainability and integrability-affect usage behavior among primary care physicians in China. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Respiratory Tract Infections (RTI)
- What is being tested?
- AI-CDSS with Stepwise Medication and Auto-extraction, AI-CDSS with Feature Importance and Auto-extraction and AI-CDSS with Feature Importance and Stepwise Medication
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3,159 participants
- Where
- 1 siteChina
- Study dates
- 5 Feb 2026to 20 May 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Be currently employed full-time in clinical practice at a primary care facility, including community health centers, community health stations, township hospitals, or village clinics;
- Hold a clinical medical license with a specialty in general practice or internal medicine, and have experience in diagnosing and managing respiratory tract infections;
- Have at least one year of clinical work experience;
- Be proficient in basic computer use (e.g., web browsing and online questionnaire completion), have reliable internet access, and be capable of independently completing the online experimental tasks;
- Provide voluntary informed consent to participate in the study.
Who cannot join
- Non-clinical staff (e.g., administrative personnel, pharmacists, laboratory technicians, or public health workers who do not directly provide outpatient clinical care);
- Individuals unable to independently complete the online experimental procedure or who demonstrate significant difficulty understanding the task instructions.
Trial locations and contacts
1 site in 1 country.
China1 site
Tongji Medical College of Huazhong University of Science & Technology School of Medicine and Health Management
Wuhan, Hubei
About this study
The goal of this observational experimental study is to determine how system-level features of artificial intelligence clinical decision support systems (AI-CDSS)-specifically explainability and integrability-affect usage behavior among primary care physicians in China. The study focuses on licensed primary care physicians, regardless of gender, age, years of clinical experience, or prior AI exposure.
The main questions it aims to answer are:
Read more
- Do specific AI features (e.g., feature attribution, chain-of-thought explanation, seamless workflow integration, automated data input) independently influence physicians' adoption intention, diagnostic accuracy, and their perceptions of the system's usefulness and ease of use?
- Do pairwise combinations of these AI features produce significant interaction effects-either synergistic or antagonistic-on these outcomes? Researchers will compare 32 distinct AI interface configurations generated from a 2⁶-¹ fractional factorial design (Resolution VI), each representing a unique combination of six binary AI features: (A) gradient-based feature importance (0 = absent, 1 = present), (B) chain-of-thought reasoning (0/1), (C) workflow integration (0 = multiple pop-up alerts, 1 = unified sidebar display), (D) automated data extraction (0 = manual entry, 1 = auto-populated from case text), (E) recommendation scope adapted to primary care settings (0 = restricted to essential options, 1 = full range of recommendations), and (F) model confidence display (0 = absent, 1 = present). This design enables unbiased estimation of all six main effects and all 15 two-way interactions.
Participants will:
Complete three standardized clinical case scenarios involving common respiratory infections via a web-based simulation platform; First provide an initial diagnosis and treatment plan without any AI input; Then review an AI-generated recommendation embedded with a randomly assigned combination of the six AI features; Revise their final diagnosis and prescription based on the AI suggestion; Rate their adoption intention, perceived usefulness, and perceived ease of use using validated 7-point Likert-scale items after each case.
- Conditions
- Respiratory Tract Infections (RTI)
- Being tested
- AI-CDSS with Stepwise Medication and Auto-extraction, AI-CDSS with Feature Importance and Auto-extraction, AI-CDSS with Feature Importance and Stepwise Medication, AI-CDSS with Confidence Display and Auto-extraction, AI-CDSS with Confidence Display and Stepwise Medication
- Medical subject headings
- Respiratory Tract Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AI-CDSS with Stepwise Medication and Auto-extractionBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Feature Importance and Auto-extractionBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Feature Importance; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Feature Importance and Stepwise MedicationBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Feature Importance; Stepwise Medication. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Confidence Display and Auto-extractionBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Confidence Display and Stepwise MedicationBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Stepwise Medication. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Confidence Display and Feature ImportanceBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Feature Importance. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 8)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Feature Importance; Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Chain-of-Thought Reasoning and Auto-extractionBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Auto-extraction. Inactive features: Sidebar Display; Confidence Display; Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Chain-of-Thought Reasoning and Stepwise MedicationBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Stepwise Medication. Inactive features: Sidebar Display; Confidence Display; Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Chain-of-Thought Reasoning and Feature ImportanceBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Feature Importance. Inactive features: Sidebar Display; Confidence Display; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 12)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Confidence Display. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Chain-of-Thought Reasoning and Confidence DisplayBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display. Inactive features: Sidebar Display; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 14)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 15)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Auto-extraction. Inactive features: Sidebar Display; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 16)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Stepwise Medication. Inactive features: Sidebar Display; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Sidebar Display and Auto-extractionBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Sidebar Display and Stepwise MedicationBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Stepwise Medication. Inactive features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Sidebar Display and Feature ImportanceBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Feature Importance. Inactive features: Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 20)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Feature Importance; Stepwise Medication; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Confidence Display. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Sidebar Display and Confidence DisplayBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display. Inactive features: Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 22)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display; Stepwise Medication; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 23)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display; Feature Importance; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 24)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display; Feature Importance; Stepwise Medication. Inactive features: Chain-of-Thought Reasoning; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with Sidebar Display and Chain-of-Thought ReasoningBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning. Inactive features: Confidence Display; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 26)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Stepwise Medication; Auto-extraction. Inactive features: Confidence Display; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 27)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Auto-extraction. Inactive features: Confidence Display; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 28)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication. Inactive features: Confidence Display; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 29)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Auto-extraction. Inactive features: Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 30)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication. Inactive features: Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
AI-CDSS with 4 Features (Config 31)Behavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Feature Importance. Inactive features: Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
Full-Featured AI-CDSSBehavioural
An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians.
| Study group | Role | What they receive |
|---|---|---|
| AI-CDSS Basic Configuration | No intervention | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 2 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Stepwise Medication and Auto-extraction |
| AI-CDSS Configuration 3 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Feature Importance and Auto-extraction |
| AI-CDSS Configuration 4 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Feature Importance and Stepwise Medication |
| AI-CDSS Configuration 5 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Confidence Display and Auto-extraction |
| AI-CDSS Configuration 6 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Confidence Display and Stepwise Medication |
| AI-CDSS Configuration 7 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Confidence Display and Feature Importance |
| AI-CDSS Configuration 8 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 8) |
| AI-CDSS Configuration 9 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Auto-extraction |
| AI-CDSS Configuration 10 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Stepwise Medication |
| AI-CDSS Configuration 11 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Feature Importance |
| AI-CDSS Configuration 12 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 12) |
| AI-CDSS Configuration 13 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Confidence Display |
| AI-CDSS Configuration 14 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 14) |
| AI-CDSS Configuration 15 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 15) |
| AI-CDSS Configuration 16 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 16) |
| AI-CDSS Configuration 17 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Sidebar Display and Auto-extraction |
| AI-CDSS Configuration 18 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Sidebar Display and Stepwise Medication |
| AI-CDSS Configuration 19 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Sidebar Display and Feature Importance |
| AI-CDSS Configuration 20 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 20) |
| AI-CDSS Configuration 21 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Sidebar Display and Confidence Display |
| AI-CDSS Configuration 22 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 22) |
| AI-CDSS Configuration 23 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 23) |
| AI-CDSS Configuration 24 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 24) |
| AI-CDSS Configuration 25 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with Sidebar Display and Chain-of-Thought Reasoning |
| AI-CDSS Configuration 26 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 26) |
| AI-CDSS Configuration 27 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 27) |
| AI-CDSS Configuration 28 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 28) |
| AI-CDSS Configuration 29 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 29) |
| AI-CDSS Configuration 30 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 30) |
| AI-CDSS Configuration 31 | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: AI-CDSS with 4 Features (Config 31) |
| AI-CDSS Full Configuration | Experimental | Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. Receives: Behavioral: Full-Featured AI-CDSS |
What is being measured
The primary outcome is the main question the study is designed to answer.
Correction Event Rate
Proportion of cases where the physician's initial decision was incorrect, but was corrected to the right decision after viewing AI recommendations. Calculated as: (Number of cases where initial decision was wrong AND final decision was correct) / (Total number of cases where initial decision was wrong). This measures the positive corrective influence of AI-CDSS on physician decision-making. Continuous variable ranging from 0 to 1.
Measured: Immediately after intervention
Misleading Event Rate
Proportion of cases where the physician's initial decision was correct, but was changed to an incorrect decision after viewing AI recommendations. Calculated as: (Number of cases where initial decision was correct AND final decision was wrong) / (Total number of cases where initial decision was correct). This measures the potential negative influence of AI-CDSS on physician decision-making. Continuous variable ranging from 0 to 1.
Measured: Immediately after intervention
Diagnostic Accuracy (Top-1)
Proportion of cases where the physician's final primary diagnosis (first-ranked diagnosis) matches the correct diagnosis (gold standard). Measured separately for initial diagnosis (before AI) and final diagnosis (after AI) to assess AI impact on diagnostic accuracy. Continuous variable ranging from 0 to 1.
Measured: Immediately after intervention
Diagnostic Accuracy (Top-3)
Proportion of cases where the correct diagnosis (gold standard) appears within the physician's top 3 differential diagnoses. Measured separately for initial diagnosis (before AI) and final diagnosis (after AI). This captures whether the correct diagnosis was considered even if not ranked first. Continuous variable ranging from 0 to 1.
Measured: Immediately after intervention
Appropriateness of Antibiotic Use Decision
Proportion of cases where the physician's final decision on whether to prescribe antibiotics (yes/no) aligns with evidence-based guidelines (gold standard). This measures the appropriateness of the binary decision to use or withhold antibiotics, regardless of the specific antibiotic chosen. Measured separately for initial decision (before AI) and final decision (after AI). Continuous variable ranging from 0 to 1.
Measured: Immediately after intervention
Appropriateness of Antibiotic Selection
Among cases where antibiotics were prescribed, proportion of cases where the physician's final antibiotic selection (specific drug choice) aligns with evidence-based guidelines (gold standard). This measures the appropriateness of the specific antibiotic chosen, conditional on the decision to prescribe. Measured separately for initial selection (before AI) and final selection (after AI). Continuous variable ranging from 0 to 1.
Measured: Immediately after intervention
Secondary outcomes (4)
Decision Certainty
Physician's self-reported confidence level in their final clinical decision after viewing AI recommendations. Measured using a 5-point Likert scale: 1 = Very Uncertain, 2 = Uncertain, 3 = Neutral, 4 = Certain, 5 = Very Certain. This reflects the cognitive impact of AI-CDSS on decision confidence.
Measured: Immediately after intervention
Intention to Adopt AI-CDSS
Measured using a 3-item scale adapted from the Technology Acceptance Model (TAM). Items assess: (1) willingness to apply AI-CDSS in daily clinical practice when available, (2) intention to use AI-CDSS based on actual patient care needs, and (3) willingness to frequently use AI-CDSS when conditions permit. Each item is rated on a 5-point Likert scale (1=Strongly Disagree to 5=Strongly Agree). Total score ranges from 3 to 15.
Measured: Immediately after intervention
Perceived Usefulness of AI-CDSS
Measured using a 6-item Perceived Usefulness scale adapted from TAM (Davis, 1989). Items assess perceived improvements in: (1) task completion speed, (2) job performance, (3) productivity, (4) work effectiveness, (5) ease of work, and (6) overall usefulness. Each item is rated on a 7-point Likert scale (1=Strongly Disagree to 7=Strongly Agree). Total score ranges from 6 to 42.
Measured: Immediately after intervention
Perceived Ease of Use of AI-CDSS
Measured using a 6-item Perceived Ease of Use scale adapted from TAM (Davis, 1989). Items assess: (1) ease of learning, (2) ease of getting desired functions, (3) clarity of interaction, (4) flexibility of interaction, (5) ease of becoming proficient, and (6) overall ease of use. Each item is rated on a 7-point Likert scale (1=Strongly Disagree to 7=Strongly Agree). Total score ranges from 6 to 42.
Measured: Immediately after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Feb 2026
- Study start5 Feb 2026
- Primary completion20 May 2026
- Study completion20 May 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Respiratory Tract Infections (RTI)Studies of the same condition, open and under way.
- More trials run by Huazhong University of Science and TechnologyThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 3,159 participants (actual)
Sponsor and investigators
- Lead sponsor
- Huazhong University of Science and Technology
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Yushu Liu, Huazhong University of Science and Technology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07401979
- Sponsor's protocol ID
- CXL202601141106
- Status last verified
- Feb 2026
- First submitted
- 19 Jan 2026
- Last updated
- 27 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Influence of Explainability and Integrability of AI-CDSS on Usage Behavior Among Primary Care Physicians
- ClinicalTrials.gov ID
- NCT07401979
- Acronym / sponsor ID
- CXL202601141106
- Conditions
- Respiratory Tract Infections (RTI)
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 3,159 participants (actual)
- Lead sponsor
- Huazhong University of Science and TechnologyUniversity, hospital or other
- Study start
- 5 Feb 2026 (actual)
- Primary completion
- 20 May 2026 (actual)
- Study completion
- 20 May 2026 (actual)
- First posted
- 11 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this observational experimental study is to determine how system-level features of artificial intelligence clinical decision support systems (AI-CDSS)-specifically explainability and integrability-affect usage behavior among primary care physicians in China. The study focuses on licensed primary care physicians, regardless of gender, age, years of clinical experience, or prior AI exposure.
The main questions it aims to answer are:
- Do specific AI features (e.g., feature attribution, chain-of-thought explanation, seamless workflow integration, automated data input) independently influence physicians' adoption intention, diagnostic accuracy, and their perceptions of the system's usefulness and ease of use?
- Do pairwise combinations of these AI features produce significant interaction effects-either synergistic or antagonistic-on these outcomes? Researchers will compare 32 distinct AI interface configurations generated from a 2⁶-¹ fractional factorial design (Resolution VI), each representing a unique combination of six binary AI features: (A) gradient-based feature importance (0 = absent, 1 = present), (B) chain-of-thought reasoning (0/1), (C) workflow integration (0 = multiple pop-up alerts, 1 = unified sidebar display), (D) automated data extraction (0 = manual entry, 1 = auto-populated from case text), (E) recommendation scope adapted to primary care settings (0 = restricted to essential options, 1 = full range of recommendations), and (F) model confidence display (0 = absent, 1 = present). This design enables unbiased estimation of all six main effects and all 15 two-way interactions.
Participants will:
Complete three standardized clinical case scenarios involving common respiratory infections via a web-based simulation platform; First provide an initial diagnosis and treatment plan without any AI input; Then review an AI-generated recommendation embedded with a randomly assigned combination of the six AI features; Revise their final diagnosis and prescription based on the AI suggestion; Rate their adoption intention, perceived usefulness, and perceived ease of use using validated 7-point Likert-scale items after each case.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Single blind (participant)
- Number of arms
- 32
| Arm | Type | Receives |
|---|---|---|
| AI-CDSS Basic Configuration | No intervention | –Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 2 | Experimental | Behavioral: AI-CDSS with Stepwise Medication and Auto-extractionParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 3 | Experimental | Behavioral: AI-CDSS with Feature Importance and Auto-extractionParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 4 | Experimental | Behavioral: AI-CDSS with Feature Importance and Stepwise MedicationParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 5 | Experimental | Behavioral: AI-CDSS with Confidence Display and Auto-extractionParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 6 | Experimental | Behavioral: AI-CDSS with Confidence Display and Stepwise MedicationParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 7 | Experimental | Behavioral: AI-CDSS with Confidence Display and Feature ImportanceParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 8 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 8)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 9 | Experimental | Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Auto-extractionParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 10 | Experimental | Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Stepwise MedicationParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 11 | Experimental | Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Feature ImportanceParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 12 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 12)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 13 | Experimental | Behavioral: AI-CDSS with Chain-of-Thought Reasoning and Confidence DisplayParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 14 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 14)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 15 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 15)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 16 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 16)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (disabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 17 | Experimental | Behavioral: AI-CDSS with Sidebar Display and Auto-extractionParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 18 | Experimental | Behavioral: AI-CDSS with Sidebar Display and Stepwise MedicationParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 19 | Experimental | Behavioral: AI-CDSS with Sidebar Display and Feature ImportanceParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 20 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 20)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 21 | Experimental | Behavioral: AI-CDSS with Sidebar Display and Confidence DisplayParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 22 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 22)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 23 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 23)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 24 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 24)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (disabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 25 | Experimental | Behavioral: AI-CDSS with Sidebar Display and Chain-of-Thought ReasoningParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 26 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 26)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 27 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 27)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 28 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 28)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (disabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 29 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 29)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (disabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 30 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 30)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (disabled), Stepwise Medication (enabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Configuration 31 | Experimental | Behavioral: AI-CDSS with 4 Features (Config 31)Participants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (disabled), Auto-extraction (disabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
| AI-CDSS Full Configuration | Experimental | Behavioral: Full-Featured AI-CDSSParticipants interact with an AI Clinical Decision Support System with the following feature settings: Sidebar Display (enabled), Chain-of-Thought Reasoning (enabled), Confidence Display (enabled), Feature Importance (enabled), Stepwise Medication (enabled), Auto-extraction (enabled). Participants complete 3 clinical case evaluations for respiratory tract infections using this AI configuration. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Be currently employed full-time in clinical practice at a primary care facility, including community health centers, community health stations, township hospitals, or village clinics;
- Hold a clinical medical license with a specialty in general practice or internal medicine, and have experience in diagnosing and managing respiratory tract infections;
- Have at least one year of clinical work experience;
- Be proficient in basic computer use (e.g., web browsing and online questionnaire completion), have reliable internet access, and be capable of independently completing the online experimental tasks;
- Provide voluntary informed consent to participate in the study.
Key exclusion criteria (2 listed)
- Non-clinical staff (e.g., administrative personnel, pharmacists, laboratory technicians, or public health workers who do not directly provide outpatient clinical care);
- Individuals unable to independently complete the online experimental procedure or who demonstrate significant difficulty understanding the task instructions.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AI-CDSS with Stepwise Medication and Auto-extractionAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 2 |
| AI-CDSS with Feature Importance and Auto-extractionAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Feature Importance; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 3 |
| AI-CDSS with Feature Importance and Stepwise MedicationAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Feature Importance; Stepwise Medication. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 4 |
| AI-CDSS with Confidence Display and Auto-extractionAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 5 |
| AI-CDSS with Confidence Display and Stepwise MedicationAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Stepwise Medication. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 6 |
| AI-CDSS with Confidence Display and Feature ImportanceAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Feature Importance. Inactive features: Sidebar Display; Chain-of-Thought Reasoning; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 7 |
| AI-CDSS with 4 Features (Config 8)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Confidence Display; Feature Importance; Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Chain-of-Thought Reasoning. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 8 |
| AI-CDSS with Chain-of-Thought Reasoning and Auto-extractionAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Auto-extraction. Inactive features: Sidebar Display; Confidence Display; Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 9 |
| AI-CDSS with Chain-of-Thought Reasoning and Stepwise MedicationAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Stepwise Medication. Inactive features: Sidebar Display; Confidence Display; Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 10 |
| AI-CDSS with Chain-of-Thought Reasoning and Feature ImportanceAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Feature Importance. Inactive features: Sidebar Display; Confidence Display; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 11 |
| AI-CDSS with 4 Features (Config 12)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Confidence Display. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 12 |
| AI-CDSS with Chain-of-Thought Reasoning and Confidence DisplayAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display. Inactive features: Sidebar Display; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 13 |
| AI-CDSS with 4 Features (Config 14)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication; Auto-extraction. Inactive features: Sidebar Display; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 14 |
| AI-CDSS with 4 Features (Config 15)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Auto-extraction. Inactive features: Sidebar Display; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 15 |
| AI-CDSS with 4 Features (Config 16)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Stepwise Medication. Inactive features: Sidebar Display; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 16 |
| AI-CDSS with Sidebar Display and Auto-extractionAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 17 |
| AI-CDSS with Sidebar Display and Stepwise MedicationAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Stepwise Medication. Inactive features: Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 18 |
| AI-CDSS with Sidebar Display and Feature ImportanceAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Feature Importance. Inactive features: Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 19 |
| AI-CDSS with 4 Features (Config 20)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Feature Importance; Stepwise Medication; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Confidence Display. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 20 |
| AI-CDSS with Sidebar Display and Confidence DisplayAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display. Inactive features: Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 21 |
| AI-CDSS with 4 Features (Config 22)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display; Stepwise Medication; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 22 |
| AI-CDSS with 4 Features (Config 23)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display; Feature Importance; Auto-extraction. Inactive features: Chain-of-Thought Reasoning; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 23 |
| AI-CDSS with 4 Features (Config 24)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Confidence Display; Feature Importance; Stepwise Medication. Inactive features: Chain-of-Thought Reasoning; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 24 |
| AI-CDSS with Sidebar Display and Chain-of-Thought ReasoningAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning. Inactive features: Confidence Display; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 25 |
| AI-CDSS with 4 Features (Config 26)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Stepwise Medication; Auto-extraction. Inactive features: Confidence Display; Feature Importance. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 26 |
| AI-CDSS with 4 Features (Config 27)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Auto-extraction. Inactive features: Confidence Display; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 27 |
| AI-CDSS with 4 Features (Config 28)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Feature Importance; Stepwise Medication. Inactive features: Confidence Display; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 28 |
| AI-CDSS with 4 Features (Config 29)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Auto-extraction. Inactive features: Feature Importance; Stepwise Medication. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 29 |
| AI-CDSS with 4 Features (Config 30)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Stepwise Medication. Inactive features: Feature Importance; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 30 |
| AI-CDSS with 4 Features (Config 31)An artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Feature Importance. Inactive features: Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Configuration 31 |
| Full-Featured AI-CDSSAn artificial intelligence-based Clinical Decision Support System for respiratory tract infections. Active features: Sidebar Display; Chain-of-Thought Reasoning; Confidence Display; Feature Importance; Stepwise Medication; Auto-extraction. The system provides diagnosis suggestions and antibiotic recommendations for primary care physicians. | Behavioural | AI-CDSS Full Configuration |
Primary outcome
Correction Event Rate
Time frame: Immediately after intervention
Proportion of cases where the physician's initial decision was incorrect, but was corrected to the right decision after viewing AI recommendations. Calculated as: (Number of cases where initial decision was wrong AND final decision was correct) / (Total number of cases where initial decision was wrong). This measures the positive corrective influence of AI-CDSS on physician decision-making. Continuous variable ranging from 0 to 1.
Misleading Event Rate
Time frame: Immediately after intervention
Proportion of cases where the physician's initial decision was correct, but was changed to an incorrect decision after viewing AI recommendations. Calculated as: (Number of cases where initial decision was correct AND final decision was wrong) / (Total number of cases where initial decision was correct). This measures the potential negative influence of AI-CDSS on physician decision-making. Continuous variable ranging from 0 to 1.
Diagnostic Accuracy (Top-1)
Time frame: Immediately after intervention
Proportion of cases where the physician's final primary diagnosis (first-ranked diagnosis) matches the correct diagnosis (gold standard). Measured separately for initial diagnosis (before AI) and final diagnosis (after AI) to assess AI impact on diagnostic accuracy. Continuous variable ranging from 0 to 1.
Diagnostic Accuracy (Top-3)
Time frame: Immediately after intervention
Proportion of cases where the correct diagnosis (gold standard) appears within the physician's top 3 differential diagnoses. Measured separately for initial diagnosis (before AI) and final diagnosis (after AI). This captures whether the correct diagnosis was considered even if not ranked first. Continuous variable ranging from 0 to 1.
Appropriateness of Antibiotic Use Decision
Time frame: Immediately after intervention
Proportion of cases where the physician's final decision on whether to prescribe antibiotics (yes/no) aligns with evidence-based guidelines (gold standard). This measures the appropriateness of the binary decision to use or withhold antibiotics, regardless of the specific antibiotic chosen. Measured separately for initial decision (before AI) and final decision (after AI). Continuous variable ranging from 0 to 1.
Appropriateness of Antibiotic Selection
Time frame: Immediately after intervention
Among cases where antibiotics were prescribed, proportion of cases where the physician's final antibiotic selection (specific drug choice) aligns with evidence-based guidelines (gold standard). This measures the appropriateness of the specific antibiotic chosen, conditional on the decision to prescribe. Measured separately for initial selection (before AI) and final selection (after AI). Continuous variable ranging from 0 to 1.
4 secondary outcomes
Decision Certainty
Time frame: Immediately after intervention
Intention to Adopt AI-CDSS
Time frame: Immediately after intervention
Perceived Usefulness of AI-CDSS
Time frame: Immediately after intervention
Perceived Ease of Use of AI-CDSS
Time frame: Immediately after intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Oct 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing AI-CDSS with Stepwise Medication and Auto-extraction, AI-CDSS with Feature Importance and Auto-extraction and AI-CDSS with Feature Importance and Stepwise Medication in people with Respiratory Tract Infections (RTI), run by Huazhong University of Science and Technology at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Correction Event Rate (time frame: Immediately after intervention). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Oct 2026.