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Training Diagnostic Specialists to Use Artificial Intelligence Safely: The DISCORD-Dx Study
Sponsor: Sara Reza
Summary
This randomized study evaluated whether a structured reasoning strategy called DISCORD-Dx could help specialist doctors use artificial intelligence (AI) recommendations more safely during diagnostic decision-making. The strategy was designed to help specialists benefit from correct AI advice while resisting plausible but incorrect AI recommendations. Forty-six consultant specialists in pathology and diagnostic radiology from two hospitals in Bahawalpur, Pakistan, were randomly assigned to receive either DISCORD-Dx training or time-matched conventional AI-literacy training. During assessment, participants first recorded and locked their own diagnosis before seeing a standardized AI recommendation. They then reviewed the AI advice and entered a final diagnosis. The AI recommendations included both correct recommendations and deliberately generated plausible errors that had been independently reviewed by specialists. The main outcome was appropriate reliance on AI, defined as following correct AI advice or resisting erroneous AI advice immediately after training. Other outcomes included harmful switching from a correct diagnosis to an incorrect diagnosis after erroneous AI advice, over-reliance, under-reliance, final diagnostic accuracy, decision time, and appropriate reliance at 8 weeks. No participant interacted with a live AI system, and study responses did not affect patient care.
Official title: DISCORD-Dx as a Cognitive Strategy for Calibrated Reliance on AI in Diagnosis
Key Details
Gender
All
Age Range
Any - Any
Study Type
INTERVENTIONAL
Enrollment
46
Start Date
2026-06-06
Completion Date
2026-09-02
Last Updated
2026-09-28
Healthy Volunteers
Yes
Interventions
DISCORD-Dx Training
A structured 40-minute cognitive training intervention delivered after a common 20-minute AI-safety orientation. The DISCORD-Dx module taught seven steps: Diagnose independently; Inspect AI advice; Substantiate evidence; Classify disagreement; Override, modify, or accept; Review outcome; and Demonstrate transfer. Guided practice cases were included, and delivery was standardized using locked scripts and fidelity checklists.
Conventional AI-Literacy Training
A 40-minute active-control training intervention delivered after the same 20-minute AI-safety orientation. It reinforced conventional principles of AI literacy through matched case discussion but did not include the DISCORD-Dx mnemonic, disagreement taxonomy, or the explicit accept/modify/override sequence. Contact time, facilitator exposure, presentation format, and practice exposure were matched to the intervention group.
Locations (1)
Quaid-e-Azam Medical College
Bahawalpur, Punjab Province, Pakistan