AI Stroke Tool Improves Outcomes & Care Quality: China Study
A clinical decision support system powered by artificial intelligence has demonstrated a significant reduction in subsequent vascular events – including stroke, heart attack, and related deaths – among patients with acute ischemic stroke in China, according to a study published today in The BMJ.
The large-scale, cluster-randomized clinical trial, involving 21,603 patients admitted to 77 hospitals, found that the AI-assisted tool, which analyzes brain scans and provides treatment recommendations, reduced the incidence of new vascular events by 26% at three months and 27% at twelve months compared to standard care. Specifically, at three months, 2.9% of patients receiving support from the system experienced a new vascular event, compared to 3.9% in the control group. This translated to 320 patients in the intervention group and 416 in the control group.
The system, known as a stroke clinical decision support system (CDSS), was implemented in 38 hospitals, even as the remaining 39 hospitals continued with usual medical care. Physicians in the intervention group received training on the system, which factors in patient characteristics such as age, medical history, and lifestyle. The study ran from January 2021 to June 2023, capturing patients within seven days of experiencing initial stroke symptoms.
Researchers similarly observed improvements in the quality of stroke care delivered to patients utilizing the CDSS, with 91.4% meeting performance measures compared to 89.8% in the control group. However, the trial did not reveal statistically significant differences in disability rates, all-cause mortality, or the incidence of bleeding complications between the two groups.
The findings come as stroke continues to be a leading cause of death and long-term disability globally, with a particularly heavy burden in countries like China, according to a report on stroke research in China. A separate study highlighted in PubMed estimates the economic burden of stroke in China reached ¥247.8 billion ($PPP 58.6 billion) in direct costs and ¥704.4 billion ($PPP 166.5 billion) in indirect costs in 2018.
The study authors acknowledge limitations, including the randomization of hospitals rather than individual patients, which could introduce variability in post-discharge care. They also emphasize the system’s ease of integration into existing hospital information systems, suggesting its potential as a comprehensive management tool for both in-hospital care and secondary prevention strategies.
“The stroke CDSS offers a promising approach to providing high quality care for patients with acute ischemic stroke admitted to hospital, particularly for resource constrained regions with a heavy burden of cerebrovascular diseases like China,” the authors conclude. The research team has not yet announced plans for wider implementation or further trials.