SynthesisPloS one2016
The Effectiveness of Electronic Differential Diagnoses (DDX) Generators: A Systematic Review and Meta-Analysis.
Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- Artificial Intelligence Techniques That May Be Applied to Primary Care Data to Facilitate Earlier Diagnosis of Cancer: Systematic Review.Journal of medical Internet research · 2021Pooled it
- Association of Clinician Diagnostic Performance With Machine Learning-Based Decision Support Systems: A Systematic Review.JAMA network open · 2021Pooled it
- Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Managing diagnostic uncertainty in primary care: a systematic critical review.BMC family practice · 2017Pooled it
- Can clinical decision support systems be an asset in medical education? An experimental approach.BMC medical education · 2023Trial
- Should electronic differential diagnosis support be used early or late in the diagnostic process? A multicentre experimental study of Isabel.BMJ quality & safety · 2022Trial
- Effects of a Differential Diagnosis List of Artificial Intelligence on Differential Diagnoses by Physicians: An Exploratory Analysis of Data from a Randomized Controlled Study.International journal of environmental research and public health · 2021Trial
- Prevalence of Diagnosed Essential Tremor Using Electronic Healthcare Records: A Population-Based Study in Northeast-Central Pennsylvania.Tremor and other hyperkinetic movements (New York, N.Y.) · 2026Article
- Comparative analysis of large language models and traditional diagnostic decision support systems for rare rheumatic disease identification.EULAR rheumatology open · 2025Article
- Computerized diagnostic decision support systems-Isabel Pro versus ChatGPT-4 part II.JAMIA open · 2025Article
- Cohort study of prediction of venous thromboembolism in emergency department patients with extremity symptoms.Internal and emergency medicine · 2025Article
- Preliminary analysis of the impact of lab results on large language model generated differential diagnoses.NPJ digital medicine · 2025Article
- Article
- Large Language Models in the Diagnosis of Hand and Peripheral Nerve Injuries: An Evaluation of ChatGPT and the Isabel Differential Diagnosis Generator.Journal of hand surgery global online · 2024Article
- Comparative Study to Evaluate the Accuracy of Differential Diagnosis Lists Generated by Gemini Advanced, Gemini, and Bard for a Case Report Series Analysis: Cross-Sectional Study.JMIR medical informatics · 2024Article
- On the role of the UMLS in supporting diagnosis generation proposed by Large Language Models.Journal of biomedical informatics · 2024Article
- Accuracy Evaluation of GPT-Assisted Differential Diagnosis in Emergency Department.Diagnostics (Basel, Switzerland) · 2024Article
- Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnostic errors are costly and they can contribute to adverse patient outcomes, including avoidable deaths. Differential diagnosis (DDX) generators are electronic tools that may facilitate the diagnostic process. METHODS AND
findingsWe conducted a systematic review and meta-analysis to investigate the efficacy and utility of DDX generators. We undertook a comprehensive search of the literature including 16 databases from inception to May 2015 and specialist patient safety databases. We also searched the reference lists of included studies. Article screening, selection and data extraction were independently conducted by 2 reviewers. 36 articles met the eligibility criteria and the pooled accurate diagnosis retrieval rate of DDX tools was high with high heterogeneity (pooled rate = 0.70, 95% CI = 0.63 to 0.77; I2 = 97%, p<0.0001). DDX generators did not demonstrate improved diagnostic retrieval compared to clinicians but small improvements were seen in the before and after studies where clinicians had the opportunity to revisit their diagnoses following DDX generator consultation. Clinical utility data generally indicated high levels of user satisfaction and significant reductions in time taken to use for newer web-based tools. Lengthy differential lists and their low relevance were areas of concern and have the potential to increase diagnostic uncertainty. Data on the number of investigations ordered and on cost-effectiveness remain inconclusive.
conclusionsDDX generators have the potential to improve diagnostic practice among clinicians. However, the high levels of heterogeneity, the variable quality of the reported data and the minimal benefits observed for complex cases suggest caution. Further research needs to be undertaken in routine clinical settings with greater consideration of enablers and barriers which are likely to impact on DDX use before their use in routine clinical practice can be recommended.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.