Emergency Department Revisit Quality Review Screening: Exploring Human Decision-Making and AI Support

Quality reviews for emergency department revisits frequently miss cases outside narrow 72-hour windows due to clinical review fatigue. In an exploratory evaluation of 99 diagnosis pairs from revisits within 1–14 days, baseline GPT-4 flagged 94% of cases for audit—far exceeding human clinicians. By channeling model outputs through a clinical knowledge graph algorithm, researchers achieved an 83–100% positive predictive value relative to physician consensus, demonstrating a viable way to expand review coverage without overwhelming hospital quality teams.