An AI-Based CDSS for Integrated Management of Patients With Acute Ischemic Stroke(GOLDEN BRIDGE II)
An AI-Based CDSS for Integrated Management of Patients With Acute Ischemic Stroke(GOLDEN BRIDGE II)
This study will conduct a cluster randomized controlled trial to evaluate the impact of an
 artificial intelligence-based clinical decision support system for the integrated management
 of patients with acute ischemic stroke on the adherence to guideline-based therapies and the
 incidence of new clinical vascular events.
Artificial intelligence (AI) and clinical decision support system (CDSS) have demonstrated
 great progress in the diagnosis and treatment of cerebrovascular diseases.CDSS can use
 computer technology to simulate and extend expert knowledge and empirical evidence in a
 timely and efficient manner. The combination of AI and CDSS is a potential solution to the
 shortage of medical resources and can improve the quality of and promote the standardization
 of medical services. At intervention sites, neurologists will receive support on use of the
 AI-based CDSS.

 Aim: To evaluate the effectiveness of an AI-based CDSS for stroke management in patients with
 acute ischemic stroke within 7 days of symptom onset.

 Intervention: An AI-based CDSS for an integrated management of patients with acute ischemic
 stroke. The strategy includes automatically identifying acute stroke lesions and lesion
 patterns, automated classification of stroke subtypes and mechanisms, evidence-based alerts,
 and guideline-recommended secondary stroke prevention strategies.

 Eighty eligible hospitals in china, stratified by hospital capacity (secondary grade or
 tertiary) and economic-geographical regions (eastern, central, and western), will be
 randomized into either the CDSS group or the usual care group.
Inclusion Criteria:

 -  Cluster Inclusion Criteria:

 -  Secondary or tertiary hospitals with an emergency department and neurologic wards
 that receive patients with AIS.

 -  Hospitals with available brain MRI scans (1.5T or 3.0T).

 -  Patient Inclusion Criteria:

 -  Patients of 18 years or older.

 -  Patients admitted with neurological deficit consistent with ischemic stroke
 within 7 days of of symptoms onset. (*Symptom onset is defined by the "last seen
 normal" principle)

 -  Confirmation of new ischemic stroke by objective modality of CT scan and MRI (had
 relevant lesions on DWI).

 -  Informed consent from patient or legally authorised representative (primarily
 spouse, parents, adult children, otherwise indicated).

 Exclusion Criteria:

 -  Cluster Exclusion Criteria:

 -  Grade-one hospitals and rural hospitals.

 -  The specialized hospitals, such as women and children specialist hospital and
 tumor hospital.

 -  Hospitals with less than 20 patients with suspected AIS per month.

 -  Patient Exclusion Criteria:

 -  Diagnosed DWI negative stroke.

 -  Diagnosed other types of cerebrovascular diseases, such as transient ischaemic
 attack, hemorrhagic stroke, cerebral venous sinus thrombosis, and so on.

 -  Diagnosed non cerebral vascular disease, such as stroke mimic, seizures, central
 nervous system infections, metabolic encephalopathy, and so on.

 -  Received carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS).

 -  Involving in other investigational drug or device clinical trials.

 -  Patients with malignant disease and life expectancy of less than 3 months or
 patients who are unable to complete the study for other reasons.

 -  Women who are pregnant or postpartum (≤6 weeks).

 -  Patients refuse to participate in this study.