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CancerENLIGHTNCT07741058

AI-Augmented Diagnostic Assessment With ENLIGHT Versus Independent Pathologist Review

A study testing Unaided Review First, Then AI as Double-Check, Then AI as First-Look., Unaided Review First, Then AI as First-Look, Then AI as Double-Check. and AI as Double-Check First, Then AI as First-Look, Then Unaided Review. in people with Cancer, run by Harvard Medical School (HMS and HSDM) at 1 site in United States.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

This study will evaluate whether artificial intelligence (AI) can enhance clinicians' accuracy, efficiency, and confidence in distinguishing lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC) and kidney renal papillary cell carcinoma (KIRP) from kidney renal clear cell carcinoma (KIRC) using digitized… Read more about this study

Who is it for?
Any age
Conditions the study is for
Cancer
What is being tested?
Unaided Review First, Then AI as Double-Check, Then AI as First-Look., Unaided Review First, Then AI as First-Look, Then AI as Double-Check. and AI as Double-Check First, Then AI as First-Look, Then Unaided Review.
Could I receive a placebo?
No, everyone receives an active treatment
How many people
25 participants
Where
1 siteUnited States
Study dates
Jul 2026to Aug 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Hematoxylin and eosin (H\&E)-stained pathology slides
  • Final diagnosis confirmed through molecular testing in conjunction with expert pathology evaluation
  • Board-certified or board-eligible pathologists
  • Willingness to complete both unaided and AI-assisted review sessions

Who cannot join

  • Poor-quality or unreadable slides
  • Cases used in AI training

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site
  • Harvard Medical School,

    Boston, Massachusetts, 02115

Other trials in United States

About this study

This study will evaluate whether artificial intelligence (AI) can enhance clinicians' accuracy, efficiency, and confidence in distinguishing lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC) and kidney renal papillary cell carcinoma (KIRP) from kidney renal clear cell carcinoma (KIRC) using digitized pathology slides. These subtype classifications are routinely performed by pathologists but can be challenging and time-consuming, particularly in difficult cases.

During the study, participating clinicians will review lung and kidney pathology slides under three different conditions:

Read more
  • Unaided Review: Diagnosis without AI assistance.
  • AI as Double-Check: The clinician first makes an independent diagnosis, after which the AI-generated diagnosis (prediction only or prediction with explanation) is revealed for review.
  • AI as First-Look: The AI-generated diagnosis (prediction only or prediction with explanation) is presented before the clinician begins the review.

Clinicians will be randomly assigned to different review sequences to minimize potential order effects. This study design will enable us to assess the impact of AI assistance on diagnostic accuracy, interpretation time, and clinician confidence.

Read the detailed description

This study aims to evaluate the effect of artificial intelligence (AI) assistance on clinicians' diagnostic performance in distinguishing lung adenocarcinoma (LUAD) from lung squamous cell carcinoma (LUSC) and kidney renal papillary cell carcinoma (KIRP) from kidney renal clear cell carcinoma (KIRC) using digitized hematoxylin and eosin (H\&E)-stained whole-slide images (WSIs). ENLIGHT (Explainable Neoplasm Learning In Grounded Histology Terms) will serve as the AI system under evaluation. This is a single-session, within-reader, between-case study in which each reader evaluates distinct sets of cases under all study conditions.

The study includes three diagnostic blocks: Block X, in which WSIs are reviewed without AI assistance; Block Y1, in which clinicians make an initial diagnosis before viewing the AI output as a double-check; and Block Y2, in which the AI output is displayed before clinicians begin their review as a first-look aid. Within each AI-assisted block, the prediction-only and prediction-with-explanation sub-blocks are presented in randomized order.

Each participating pathologist will review up to 400 de-identified WSIs (up to 200 lung cancer and up to 200 kidney cancer cases). Readers will be randomly assigned to one of four study arms that differ only in the order in which Blocks X, Y1, and Y2 are completed. For each reader, distinct WSIs will be randomly assigned to the diagnostic conditions so that no WSI is reviewed more than once by the same reader.

  • Arm 1 (X -> Y1 -> Y2): Clinicians first complete Block X (Unaided Review), followed by Block Y1 (AI as Double-Check) and then Block Y2 (AI as First-Look).
  • Arm 2 (X -> Y2 -> Y1): Clinicians first complete Block X (Unaided Review), followed by Block Y2 (AI as First-Look) and then Block Y1 (AI as Double-Check).
  • Arm 3 (Y1 -> Y2 -> X): Clinicians first complete Block Y1 (AI as Double-Check), followed by Block Y2 (AI as First-Look), and then Block X (Unaided Review).
  • Arm 4 (Y2 -> Y1 -> X): Clinicians first complete Block Y2 (AI as First-Look), followed by Block Y1 (AI as Double-Check), and then Block X (Unaided Review).

For each case, diagnostic accuracy, time to diagnosis, and diagnostic confidence will be recorded. No reader will review the same WSI under more than one condition, thereby eliminating within-reader recall bias. In parallel, the ENLIGHT model will independently generate diagnostic predictions for all WSIs to enable direct benchmarking of AI performance against pathologists and to evaluate the impact of different AI-assisted workflows on diagnostic performance.

Conditions
Cancer
Being tested
Unaided Review First, Then AI as Double-Check, Then AI as First-Look., Unaided Review First, Then AI as First-Look, Then AI as Double-Check., AI as Double-Check First, Then AI as First-Look, Then Unaided Review., AI as First-Look First, Then AI as Double-Check, Then Unaided Review.
Keywords
AI-Augmented Diagnosis, Multimodal AI, Explainable AI, Cancer Diagnosis, Cancer Subtyping, Whole-Slide Imaging
Medical subject headings
Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Unaided Review First, Then AI as Double-Check, Then AI as First-Look.Behavioural

    Readers first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.

  • Unaided Review First, Then AI as First-Look, Then AI as Double-Check.Behavioural

    Readers first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.

  • AI as Double-Check First, Then AI as First-Look, Then Unaided Review.Behavioural

    Readers first complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.

  • AI as First-Look First, Then AI as Double-Check, Then Unaided Review.Behavioural

    Readers first complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, SX, SY1a, SY1b, SY2a, and SY2b are disjoint.

Study groups in NCT07741058
Study groupRoleWhat they receive
Unaided Review First, Then AI as Double-Check, Then AI as First-Look.Active comparatorReaders first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Receives: Behavioral: Unaided Review First, Then AI as Double-Check, Then AI as First-Look.
Unaided Review First, Then AI as First-Look, Then AI as Double-Check.Active comparatorReaders first complete Block X (Unaided) on their assigned subset SX. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Receives: Behavioral: Unaided Review First, Then AI as First-Look, Then AI as Double-Check.
AI as Double-Check Review First, Then AI as First-Look, Then Unaided Review.Active comparatorReaders first complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. They then complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Receives: Behavioral: AI as Double-Check First, Then AI as First-Look, Then Unaided Review.
AI as First-Look Review First, Then AI as Double-Check, Then Unaided Review.Active comparatorReaders first complete Block Y2 (AI as First-Look) on two separate subsets: SY2a (AI prediction-only as First-Look) and SY2b (AI prediction-with-explanation as First-Look). Within Block Y2, the order of SY2a and SY2b is randomized. They then complete Block Y1 (AI as Double-Check) on two separate subsets: SY1a (AI prediction-only as Double-Check) and SY1b (AI prediction-with-explanation as Double-Check). Within Block Y1, the order of SY1a and SY1b is randomized. Then readers complete Block X (Unaided) on their assigned subset SX. For each reader, each of the five subsets (SX, SY1a, SY1b, SY2a, and SY2b) comprises up to 80 slides: up to 40 slides from LUAD-LUSC and up to 40 slides from KIRP-KIRC.
Receives: Behavioral: AI as First-Look First, Then AI as Double-Check, Then Unaided Review.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Diagnostic performance of cancers

    Performance of clinicians (unaided and AI-assisted) for distinguishing LUAD- LUSC and distinguishing KIRP-KIRC, measured in accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1.

    Measured: Periprocedural (at the time of slide review)

Secondary outcomes (4)
  1. Time to diagnosis

    Average time (seconds per case) required to finalize a diagnosis.

    Measured: Periprocedural (at the time of slide review)

  2. Inter-observer variability

    Agreement among clinicians across conditions, measured using inter-rater reliability metrics (e.g., kappa statistics).

    Measured: Periprocedural (at the time of slide review)

  3. Net benefit after AI exposure

    The overall change in diagnostic accuracy attributable to AI assistance.

    Measured: Periprocedural (at the time of slide review)

  4. Clinician confidence level

    Self-reported diagnostic confidence recorded for each case. Scale: 5 - Absolutely Certain; 4 - Mostly Certain; 3 - Unsure; 2 - Very Doubtful; 1 - Random Guess; With 5 being the highest confidence score and 1 being the lowest.

    Measured: Periprocedural (at the time of slide review)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Aug 2026
  2. Study startJul 2026 (estimated)
  3. Primary completionAug 2026 (estimated)
  4. Study completionAug 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
25 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07741058
Sponsor's protocol ID
ENLIGHT Study
Acronym
ENLIGHT
Status last verified
Jul 2026
First submitted
28 Jul 2026
Last updated
3 Aug 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Unaided Review First, Then AI as Double-Check, Then AI as First-Look., Unaided Review First, Then AI as First-Look, Then AI as Double-Check. and AI as Double-Check First, Then AI as First-Look, Then Unaided Review. in people with Cancer, run by Harvard Medical School (HMS and HSDM) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 3 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Diagnostic performance of cancers (time frame: Periprocedural (at the time of slide review)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Aug 2026.

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