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• PULSE attained expert-competitive accuracy, outperforming residents and junior specialists while matching senior specialist performance at both Top@1 and Top@4 thresholds.result 90%
• Unlike physicians, whose accuracy declined with disease rarity, PULSE maintained stable performance across incidence tiers.result 90%
• PULSE exhibited adaptive reasoning, increasing output length with case difficulty in a manner analogous to the longer deliberation observed among expert clinicians.technical 85%
• When used collaboratively, PULSE enabled physicians to correct initial errors and broaden diagnostic hypotheses.result 85%
• PULSE introduced risks of automation bias when used collaboratively with physicians.limitation 85%
• PULSE combines a domain-tuned large language model with scientific literature retrieval to support diagnostic decision-making.method 90%
• The study explores both serial and concurrent collaboration workflows, revealing that PULSE offers robust support across common and rare presentations.result 80%
• The evaluation used a benchmark of 82 authentic endocrinology case reports encompassing a broad spectrum of disease types and incidence levels.method 90%

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