Human-LLM Dialogue Improves Diagnostic Accuracy in Emergency Care
Authors: Burcu Sayin, Ngoc Vo Hong, Ipek Baris Schlicht, Jacopo Staiano, Pasquale Minervini, Sara Allievi, Nicola Susca, Nicola Osti, +3 more
Organizations: Department of Information Engineering and Computer Science, University of Trento, Italy · Department of Medicine, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT), Trento, Italy · Universitat Politècnica de València, Spain · The University of Edinburgh, UK · Center for Medical Sciences (CISMed), University of Trento, Trento, Italy
Clinical decision-making in emergency medicine demands rapid, accurate diagnoses under uncertainty. Despite benchmark progress, evidence for LLMs as interactive aids in live physician workflows remains sparse. MedSyn lets physicians iteratively query an LLM provided with the full clinical record while initially viewing only the chief complaint. Seven physicians (three seniors, four residents) completed baseline and AI-assisted sessions across 52 MIMIC-IV cases stratified by difficulty. Blinded evaluation showed residents' Hard-case correctness rose from 0.589 to 0.734; difficulty-standardised completely-correct rates confirmed a medium effect (Δ = 0.092; p = 0.071; d = 0.47). Automated metrics corroborated these gains: standardised any-match accuracy improved by 0.156 (p < 0.0001), and residents showed the largest F1 gain (Δ = 0.138; p < 0.0001). Dialogue analysis revealed expertise-dependent strategies (seniors asked targeted, hypothesis-driven questions; residents relied on broader queries) and cross-expertise concordance increased (Δ = 0.145; p < 0.0001). Interactive LLM support meaningfully enhances diagnostic reasoning.