Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial

Abstract Background The role of appropriate semantic qualifiers (SQs) in the effective use of a clinical decision support system (CDSS) is not yet fully understood. Previous studies have not investigated the input. This study aimed to investigate whether the appropriateness of SQs modified the impac...

Full description

Saved in:
Bibliographic Details
Main Authors: Yasutaka Yanagita, Kiyoshi Shikino, Daiki Yokokawa, Kosuke Ishizuka, Tomoko Tsukamoto, Yu Li, Takanori Uehara, Masatomi Ikusaka
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Medical Education
Subjects:
Online Access:https://doi.org/10.1186/s12909-025-07294-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850154822547800064
author Yasutaka Yanagita
Kiyoshi Shikino
Daiki Yokokawa
Kosuke Ishizuka
Tomoko Tsukamoto
Yu Li
Takanori Uehara
Masatomi Ikusaka
author_facet Yasutaka Yanagita
Kiyoshi Shikino
Daiki Yokokawa
Kosuke Ishizuka
Tomoko Tsukamoto
Yu Li
Takanori Uehara
Masatomi Ikusaka
author_sort Yasutaka Yanagita
collection DOAJ
description Abstract Background The role of appropriate semantic qualifiers (SQs) in the effective use of a clinical decision support system (CDSS) is not yet fully understood. Previous studies have not investigated the input. This study aimed to investigate whether the appropriateness of SQs modified the impact of CDSS on diagnostic accuracy among medical students. Methods For this randomized controlled trial, a total of forty-two fifth-year medical students in a clinical clerkship at Chiba University Hospital were enrolled from May to December 2020. They were divided into the CDSS (CDSS use; 22 participants) and control groups (no CDSS use; 20 participants). Students were presented with ten expert-developed case vignettes asking for SQs and a diagnosis. Three appropriate SQs were established for each case vignette. The participants were awarded one point for each SQ that was consistent with the set SQs. Those with two or more points were considered to have provided appropriate SQs. The CDSS used was the Current Decision SupportⓇ. We evaluated diagnostic accuracy and the appropriateness of SQ differences between the CDSS and control groups. Results Data from all 42 participants were analyzed. The CDSS and control groups provided 133 (60.5%; 220 answers) and 115 (57.5%; 200 answers) appropriate SQs, respectively. Among CDSS users, diagnostic accuracy was significantly higher with appropriate SQs compared to inappropriate SQs (χ2(1) = 4.97, p = 0.026). With appropriate SQs, diagnostic accuracy was significantly higher in the CDSS group compared to the control group (χ2(1) = 1.16 × 10, p < 0.001). With inappropriate SQs, there was no significant difference in diagnostic accuracy between the two groups (χ2(1) = 8.62 × 10–2, p = 0.769). Conclusions Medical students may make more accurate diagnoses using the CDSS if appropriate SQs are set. Improving students’ ability to set appropriate SQs may improve the effectiveness of CDSS use. Trial registration This study was registered with the University Hospital Medical Information Network Clinical Trials Registry on 24/12/2020 (Unique trial number: UMIN000042831).
format Article
id doaj-art-99a7f7fddffb437c90f061fda79f0e9f
institution OA Journals
issn 1472-6920
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Medical Education
spelling doaj-art-99a7f7fddffb437c90f061fda79f0e9f2025-08-20T02:25:11ZengBMCBMC Medical Education1472-69202025-05-012511810.1186/s12909-025-07294-5Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trialYasutaka Yanagita0Kiyoshi Shikino1Daiki Yokokawa2Kosuke Ishizuka3Tomoko Tsukamoto4Yu Li5Takanori Uehara6Masatomi Ikusaka7Department of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalDepartment of General Medicine, Chiba University HospitalAbstract Background The role of appropriate semantic qualifiers (SQs) in the effective use of a clinical decision support system (CDSS) is not yet fully understood. Previous studies have not investigated the input. This study aimed to investigate whether the appropriateness of SQs modified the impact of CDSS on diagnostic accuracy among medical students. Methods For this randomized controlled trial, a total of forty-two fifth-year medical students in a clinical clerkship at Chiba University Hospital were enrolled from May to December 2020. They were divided into the CDSS (CDSS use; 22 participants) and control groups (no CDSS use; 20 participants). Students were presented with ten expert-developed case vignettes asking for SQs and a diagnosis. Three appropriate SQs were established for each case vignette. The participants were awarded one point for each SQ that was consistent with the set SQs. Those with two or more points were considered to have provided appropriate SQs. The CDSS used was the Current Decision SupportⓇ. We evaluated diagnostic accuracy and the appropriateness of SQ differences between the CDSS and control groups. Results Data from all 42 participants were analyzed. The CDSS and control groups provided 133 (60.5%; 220 answers) and 115 (57.5%; 200 answers) appropriate SQs, respectively. Among CDSS users, diagnostic accuracy was significantly higher with appropriate SQs compared to inappropriate SQs (χ2(1) = 4.97, p = 0.026). With appropriate SQs, diagnostic accuracy was significantly higher in the CDSS group compared to the control group (χ2(1) = 1.16 × 10, p < 0.001). With inappropriate SQs, there was no significant difference in diagnostic accuracy between the two groups (χ2(1) = 8.62 × 10–2, p = 0.769). Conclusions Medical students may make more accurate diagnoses using the CDSS if appropriate SQs are set. Improving students’ ability to set appropriate SQs may improve the effectiveness of CDSS use. Trial registration This study was registered with the University Hospital Medical Information Network Clinical Trials Registry on 24/12/2020 (Unique trial number: UMIN000042831).https://doi.org/10.1186/s12909-025-07294-5Clinical decision support systemDiagnostic accuracySemantic qualifier
spellingShingle Yasutaka Yanagita
Kiyoshi Shikino
Daiki Yokokawa
Kosuke Ishizuka
Tomoko Tsukamoto
Yu Li
Takanori Uehara
Masatomi Ikusaka
Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial
BMC Medical Education
Clinical decision support system
Diagnostic accuracy
Semantic qualifier
title Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial
title_full Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial
title_fullStr Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial
title_full_unstemmed Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial
title_short Appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system: a randomized controlled trial
title_sort appropriate semantic qualifiers increase diagnostic accuracy when using a clinical decision support system a randomized controlled trial
topic Clinical decision support system
Diagnostic accuracy
Semantic qualifier
url https://doi.org/10.1186/s12909-025-07294-5
work_keys_str_mv AT yasutakayanagita appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT kiyoshishikino appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT daikiyokokawa appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT kosukeishizuka appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT tomokotsukamoto appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT yuli appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT takanoriuehara appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial
AT masatomiikusaka appropriatesemanticqualifiersincreasediagnosticaccuracywhenusingaclinicaldecisionsupportsystemarandomizedcontrolledtrial