Evaluating Diagnostic Accuracy of a New Artificial-Intelligence Driven Diagnostic Support Tool

Abstract

Background: Diagnostic decision support systems (DDSS) are computer programs aimed to improve healthcare by supporting the clinician in the process of diagnostic decision making. Previous studies demonstrated their ability to enhance clinicians’ diagnostic skills, prevent diagnostic errors, and reduce hospitalization costs. Despite their potential benefits, their utilization in clinical practice is limited, emphasizing the need for new and improved products. Therefore, in this study we aimed to conduct a primary evaluation of diagnostic performance for “Kahun”, a new artificial intelligence driven diagnostic tool. Methods: Diagnostic performance was evaluated based on the program ability to “solve” clinical cases from the USMLE®-step-2-clinical-skills board-exams simulations. Cases were entered to Kahun by three blinded physicians, unexperienced with the platform. The generated differential-diagnoses (DDX) were recorded and compared to the expected one. The cases were drawn from the case-banks of three leading preparation companies: UWorld, Amboss and FirstAid. Each case included 3“correct” differential-diagnoses. Diagnostic performance was measured in two ways. First, as sensitivity, calculated as the total number of expected DDX appropriately suggested by Kahun divided by the total number of expected diagnoses in all cases. Second, as case specific success rates, calculated as the number of cases with 1/3,2/3 and 3/3 of expected DDX appropriately suggested by Kahun divided by the total number of cases. Findings: 91 clinical cases were included in the study with 78 different chief complaints, and 174 different DDX. Kahun correctly suggested 231 diagnoses, resulting in an overall sensitivity rate of 84.9%which was stable across different disciplines. In 63.8%of the cases Kahun correctly suggested 3/3 of expected DDX within the topmost likely diagnoses, in 89%at least 2/3, and in 97.8%at least 1/3. Interpretation: Kahun demonstrates an acceptable diagnostic accuracy and comprehensiveness. Funding: None to declare. Declaration of Interest: NBS, AS and TW were employed by Kahun Medical Ltd as medical advisors. All other authors have nothing to declare.