Discussion
emergent disease
DISEASE, DISEASES
In this study, we showed that medical students tended to make diagnoses more accurately using the CDSS and Google for typical disease history, which residents should learn. For common diseases, there was no significant difference in the mean scores of correct answers between medical students, who used the CDSS and Google, and residents, indicating the usefulness of the CDSS and Google. For emergent diseases, the mean scores of medical students who used the CDSS and Google were not as high as those of residents.For easy cases, the scores of medical students using the CDSS or Google were equivalent to those of residents. For difficult cases, medical students did not reach the average score of residents even when using the CDSS and Google and when within the first three position differentials. The residents’ mean scores were almost equal for common and emergent diseases; this is possibly because they have a better understanding of disease concepts and clinical processes through clinical practice. Additionally, residents’ lower mean scores for emergent diseases may indicate that the case questions were more complicated than those for common diseases. Furthermore, as medical students mainly rotate through wards and outpatient departments, they have few opportunities to experience emergent disease care.The quality of information in the CDSS is generally assured as the medical information provided is reflective of relevant guidelines and expert opinions [No significant difference was found between the CDSS and Google groups regarding answering time. Searching with the CDSS is time-consuming and requires training to become familiar with its use. Accordingly, higher frequency of use, continued use, and increased proficiency in the CDSS are expected to help avoid diagnostic errors and improve diagnostic accuracy in daily practice. Accuracy of diagnosis decreases when time is limited [One study evaluated the diagnostic accuracy of the CDSS at the time the patient presents with the original complaint and at the time all test results are available, including the interview, physical examination, blood tests, and imaging studies [There are two issues that remain to be discussed. First, the accuracy of the CDSS must be further improved. Currently, the CDSS is reported to be sufficiently accurate in the family medicine field [Second, the CDSS requires a certain proficiency level, especially in the search method and appropriate selection of keywords, whereas the participants were accustomed to using Google regularly. Another advantage of Google is that any keywords can be used, without any constraints; they do not have to be medical terms. Meanwhile, with the CDSS, users’ basic medical knowledge would help them select appropriate medical terms and evaluate the information appropriately. As the next research step, we would like to assess the effect of CDSS use on the performance of more experienced clinicians. Clarifying the usefulness of a CDSS could guide learning on how to use medical information systems in medical education. Moreover, ChatGPT (OpenAI, San Francisco), an AI-driven system, was released at the end of 2022 and has reportedly achieved a high percentage of correct answers in the US National Medical Examination [