Report

on diagnostic performance of a sample of medical students

in the InSimu Patient app
between 2018 January and 2019 April
 EXPERIENCE GAINED IN NUMBERS
(Sample: 525 medical students)

15,715 238,069 43 years

Diagnosed patients Ordered tests Spent on examinations

The number of virtual patients The average number of diagnostic

How much time have the students
that the students diagnosed in tests that students ordered to
spent with diagnosing one patient on
the InSimu app. diagnose one patient.
average?
Average
Total 15,715 15
per patient
In a 10 min session 0:04:42
Average 30 Average
454
/user
Min 1 Min /user 0

Max 502 Max /user 8,054

Median 11 Median /user 120

 AREAS OF PRACTICE

*Specializations overlap, thus “All” is not the sum of the four specialization
 ACCURACY OF THE DIAGNOSIS
39% of the diagnoses were wrong
or “pass” or too late (“patient died”)

Internal Emergency
Result All Oncology Neurology
Medicine medicine
Perfect diagnosis 6608 1140 4500 2091 601
Overspecified 333 161 131 59 198
Not specific enough 1245 134 706 724 86
Nearly good 1278 215 879 498 31
Wrong diagnosis 4741 765 3007 1525 665
Patient died 303 0 229 256 5
Gave up 1099 153 700 316 214
*Specializations overlap, thus “All” is not the sum of the four specialization
PATHWAY COST EFFICIENCY

Students spent 39% more

on tests than optimal

Metric Description Total

The total cost of diagnostic tests ordered by students. (Based on
Ordered
U.S. Medicare prices) $7,920,398
The optimal cost of diagnostic tests using the optimal diagnostic
Optimal
pathways. (Based on U.S. Medicare prices) $5,698,234
Extra costs Extra costs of diagnostic tests $2,222,163
PATHWAY COST EFFICIENCY

In ~50% of the solved cases,

unnecessary imaging tests, laboratory
tests were ordered.

*Other tests: special modalities, e.g. biopsies, ECG, endoscopy, etc.

 PATHWAY ACCURACY

56% of the recommended tests

were missed

194,078

108,309

Metric Description Total

The total number of diagnostic tests in the optimal
Missed tests 108,309
diagnostic pathways that the students missed to order.
The total number of diagnostic tests in the optimal
Number of optimal diagnostic
diagnostic pathways for the patients solved by 194,078
tests
students.
Rate (Missed/Optimal) The rate of missed tests of all tests. 56%
 PATHWAY ACCURACY

~70% of the MISSED tests were

TOP10 most common missed tests Number of missed tests

History and Physical examinations 1. Gastrointestinal History 3927

that would have had no costs 2. General Appearance Physical 3527

3. Abdominal Physical 3451

4. Other Diseases History 3185

5. Fatigue And Weakness History 3169

6. Vital Signs Physical 3168

7. Pain History 3122

8. Social History 3024

9. Skin Physical 2972

Metric History Imaging Other Laboratory Physical
Number of missed tests
43,260 6,106 2,736 23,583 32,624 10. CBC Test 2567
per test type
 RATE OF MISSED TEST TYPES IN
DIFFERENT SPECIALIZATIONS

Internal Emergency
MISSED All Oncology Neurology
Medicine medicine
History 43260 10253 26501 11742 3648
Physical 32624 4519 17821 12134 7969
Laboratory 23583 5106 14206 9367 1675
Other 2736 668 1687 560 180
Imaging 6106 1385 3619 2463 630

*Specializations overlap, thus “All” is not the sum of the four specialization
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