{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T01:10:44Z","timestamp":1776215444991,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000936","name":"Gordon and Betty Moore Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000936","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Human Diagnosis Project","award":["5496"],"award-info":[{"award-number":["5496"]}]},{"DOI":"10.13039\/100000050","name":"National Heart Lung and Blood Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12HL138046"],"award-info":[{"award-number":["K12HL138046"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23HL136899"],"award-info":[{"award-number":["K23HL136899"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences of the NIH","doi-asserted-by":"crossref","award":["KL2TR001870"],"award-info":[{"award-number":["KL2TR001870"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute for Health\u2019s National Research Service Award","award":["T32HP19025"],"award-info":[{"award-number":["T32HP19025"]}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K24CA212294"],"award-info":[{"award-number":["K24CA212294"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study sought to evaluate if peer input on outpatient cases impacted diagnostic confidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This randomized trial of a peer input intervention occurred among 28 clinicians with case-level randomization. Encounters with diagnostic uncertainty were entered onto a digital platform to collect input from \u22655 clinicians. The primary outcome was diagnostic confidence. We used mixed-effects logistic regression analyses to assess for intervention impact on diagnostic confidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 509 cases (255 control; 254 intervention), the intervention did not impact confidence (odds ratio [OR], 1.46; 95% confidence interval [CI], 0.999-2.12), but after adjusting for clinician and case traits, the intervention was associated with higher confidence (OR, 1.53; 95% CI, 1.01-2.32). The intervention impact was greater in cases with high uncertainty (OR, 3.23; 95% CI, 1.09- 9.52).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Peer input increased diagnostic confidence primarily in high-uncertainty cases, consistent with findings that clinicians desire input primarily in cases with continued uncertainty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jamia\/ocaa278","type":"journal-article","created":{"date-parts":[[2020,10,25]],"date-time":"2020-10-25T08:07:28Z","timestamp":1603613248000},"page":"632-637","source":"Crossref","is-referenced-by-count":4,"title":["Impact of digitally acquired peer diagnostic input on diagnostic confidence in outpatient cases: A pragmatic randomized trial"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2514-3572","authenticated-orcid":false,"given":"Elaine C","family":"Khoong","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco , San Francisco, California,","place":["USA"]},{"name":"Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California, San Francisco , San Francisco, California,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0795-3237","authenticated-orcid":false,"given":"Valy","family":"Fontil","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco , San Francisco, California,","place":["USA"]},{"name":"Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California, San Francisco , San Francisco, California,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie A","family":"Rivadeneira","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco , San Francisco, California,","place":["USA"]},{"name":"Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California, San Francisco , San Francisco, California,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mekhala","family":"Hoskote","sequence":"additional","affiliation":[{"name":"Berkeley School of Public Health and UCSF School of Medicine, University of California, Berkeley\u2013University of California, San Francisco Joint Medical Program , Berkeley, California,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shantanu","family":"Nundy","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health, Department of Health Policy and Management, George Washington University , Washington, DC,","place":["USA"]},{"name":"Accolade, Inc. Plymouth Meeting , Pennsylvania,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1111-8595","authenticated-orcid":false,"given":"Courtney R","family":"Lyles","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco , San Francisco, California,","place":["USA"]},{"name":"Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California, San Francisco , San Francisco, California,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urmimala","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco , San Francisco, California,","place":["USA"]},{"name":"Center for Vulnerable 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