Evidence map›Paper›PMID 42106573›Full record

ArticleNPJ digital medicine2026

Clinician engagement shapes the impact of AI-based ECG screening for chronic liver disease in primary care.

Alberto Calleri, Yigit Yazarkan, Kan Liu, Blake A Kassmeyer, Ryan J Lennon, Puru Rattan, Amir Seid, Matthew E Bernard, Gagandeep Singh, Mark E Deyo-Svendsen and 12 more

Registry-linked trialAbstract read
In one paragraph

Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05782283 (Early Detection of Advanced Liver Disease Via Artificial Intelligence-Enabled Electrocardiogram), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05782283 nacompletednot on this map

Early Detection of Advanced Liver Disease Via Artificial Intelligence-Enabled Electrocardiogram (Advance): A Pragmatic, Cluster-Randomized Clinical Trial

TypeinterventionalSponsorMayo ClinicRan2023 to 2025Enrolled279ConditionsCirrhosisArmsACE (AI-Cirrhosis-ECG) 2.0
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Alberto CalleriDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Yigit YazarkanDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Kan LiuDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Blake A KassmeyerDivision of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA.
Ryan J LennonDivision of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA.
Puru RattanDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Amir SeidDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Matthew E BernardDepartment of Family Medicine, Mayo Clinic Health System, Rochester, MN, USA.
Gagandeep SinghDepartment of Family Medicine, Mayo Clinic Health System, Rochester, MN, USA.
Mark E Deyo-SvendsenDepartment of Family Medicine, Mayo Clinic Health System, Rochester, MN, USA.
Graham KingDepartment of Family Medicine, Mayo Clinic Health System, Rochester, MN, USA.
Stephen K StaceyDepartment of Family Medicine, Mayo Clinic Health System, Rochester, MN, USA.
Amy OlofsonDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Alina AllenDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Joseph C AhnDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Paul A FriedmanDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Patrick S KamathDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Zachi I AttiaDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Peter A NoseworthyDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Vijay H ShahDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
David RushlowDepartment of Family Medicine, Mayo Clinic Health System, Rochester, MN, USA.
Douglas A SimonettoDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Simonetto.Douglas@mayo.edu.

Funding

Mayo Clinic Center for Clinical and Translational Science (CCaTS UL1 Supplement - Dr. Timothy Curry)UL1TR002377 · NCATS · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC · 2017 to 2026
$78.4M
Integrated Therapies for Alcohol use in Alcohol-associated Liver Disease (ITAALD) – Mayo ClinicU01AA026974 · NIAAA · MAYO CLINIC ROCHESTER · PI VICTOR M. KARPYAK, VIJAY H. SHAH · 2018 to 2026
$2.9M
Liver Cirrhosis Network: Clinical Research Center - Mayo ClinicU01DK130181 · NIDDK · MAYO CLINIC ROCHESTER · PI VIJAY H. SHAH, Douglas A. Simonetto · 2021 to 2026
$1.9M
Mayo Clinic MAX Innovation Award, UL1TR002377NCATS NIH HHS UL1 TR002377NIAAA NIH HHS U01 AA026974NIDDK NIH HHS U01 DK130181
6 · The paper itself

Abstract

Artificial intelligence (AI)-based screening tools show promise for early identification of chronic liver disease (CLD), yet their effectiveness in real-world settings may depend on clinician response to AI-generated recommendations. We performed a post hoc analysis of the intervention arm of the pragmatic, cluster-randomized DULCE trial, in which primary care clinicians received electrocardiogram-based machine learning (ECG-ML) alerts indicating elevated risk for CLD. Clinicians were categorized as high engagement (HE; top quartile) or low engagement (LE), and diagnostic yield was defined as the proportion of ECG-ML-positive cases with confirmed CLD. Among 110 clinicians receiving ≥1 alert (1385 ECG-ML-positive patients), overall engagement was 29.8%. HE was associated with higher detection of advanced CLD (OR 2.12, 95% CI 1.36-3.30; p = 0.001) and any CLD (OR 2.59, 95% CI 1.83-3.68; p < 0.001) compared with LE. Diagnostic yield was 10.6% versus 2.9% for advanced CLD and 22.3% versus 5.0% for any CLD in HE versus LE (OR 2.99, 95% CI 1.73-5.16; p < 0.001 and OR 3.74, 95% CI 2.44-5.75; p < 0.001, respectively). These findings suggest that the effectiveness of AI-based screening may depend not only on algorithm performance but also on clinician engagement with AI recommendations and highlight the importance of accounting for engagement when designing and interpreting AI-enabled clinical trials. ClinicalTrials.gov NCT05782283.

Identifiers

PMID42106573
PMCPMC13377096

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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.