{"doi":"10.1093/jamia/ocaa278","title":"Impact of digitally acquired peer diagnostic input on diagnostic confidence in outpatient cases: A pragmatic randomized trial","abstract":"OBJECTIVE: The study sought to evaluate if peer input on outpatient cases impacted diagnostic confidence. MATERIALS AND METHODS: This randomized trial of a peer input intervention occurred among 28 clinicians with case-level randomization. Encounters with diagnostic uncertainty were entered onto a digital platform to collect input from ≥5 clinicians. The primary outcome was diagnostic confidence. We used mixed-effects logistic regression analyses to assess for intervention impact on diagnostic confidence. RESULTS: Among the 509 cases (255 control; 254 intervention), the intervention did not impact confidence (odds ratio [OR], 1.46; 95% confidence interval [CI], 0.999-2.12), but after adjusting for clinician and case traits, the intervention was associated with higher confidence (OR, 1.53; 95% CI, 1.01-2.32). The intervention impact was greater in cases with high uncertainty (OR, 3.23; 95% CI, 1.09- 9.52). CONCLUSIONS: Peer input increased diagnostic confidence primarily in high-uncertainty cases, consistent with findings that clinicians desire input primarily in cases with continued uncertainty.","journal":"Journal of the American Medical Informatics Association","year":2020,"id":113465,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9406,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":535329,"name":"Valy Fontil","orcid":"0000-0003-0795-3237","position":1,"is_corresponding":false},{"id":353548,"name":"Natalie A. Rivadeneira","orcid":"0000-0003-2421-9915","position":2,"is_corresponding":false},{"id":395528,"name":"Mekhala Hoskote","orcid":"0000-0002-8787-5357","position":3,"is_corresponding":false},{"id":535330,"name":"Shantanu Nundy","orcid":"0000-0001-6339-4375","position":4,"is_corresponding":false},{"id":360985,"name":"Courtney R. Lyles","orcid":"0000-0002-1111-8595","position":5,"is_corresponding":false},{"id":353553,"name":"Urmimala Sarkar","orcid":"0000-0003-4213-4405","position":6,"is_corresponding":false},{"id":356244,"name":"Elaine C. Khoong","orcid":"0000-0002-2514-3572","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-18T23:13:21.458038Z","pmid":"33260212","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}