Physician Diagnosis of Neurologic Cases With Large Language Models

The study population consists of licensed physicians who have completed at least two years of neurology training. Participants are randomly assigned in a 1:1 ratio to the LLM assistance group or the conventional assistance group. In the LLM assistance group, physicians are assisted by an in-house LLM and are allowed to use conventional resources (e.g., search engines, UpToDate, or clinical guidelines) before submitting a final diagnosis. Access to any other LLMs is not permitted. In the conventional assistance group, physicians use only conventional resources and do not have access to the in-house LLM or any other LLMs at any point during the study. The primary outcome is top-1 diagnostic accuracy. Secondary outcomes include top-3 diagnostic accuracy, the time required to complete each case, and physicians' diagnostic confidence.