Effect of a clinical decision support system on stroke care quality and outcomes in patients with acute ischaemic stroke (GOLDEN BRIDGE II): cluster randomised clinical trial

作者：Xinmiao Zhang, Lingling Ding, Jing Jing, Chunjuan Wang, Hongqiu Gu, Yong Jiang, Xia Meng, Tao Liu, XueWei Peng YingGang Xie, Man Xu, Meera Hu, Yanxu Zhang, He Fu, Pan Liu, Chunying Du, Kejin Du, Mengdi Wang, Hongxia Li, Xiping Gong, Kehui Dong, Yunyun Xiong, Yilong Wang, Liping Liu, Z. Zhang, Yingzhuo Zang, Chunxiang Yang, Ying Xian, Eric Peterson, Gregg C Fonarow, Lee H Schwamm, Xinyu Zhao, Yongjun Wang, Zixiao Li · 发表于：BMJ · 年份：2026 · DOI：10.1136/bmj-2025-085810 · 被引用次数：5 · 研究领域：Acute Ischemic Stroke Management、Artificial Intelligence in Healthcare and Education、Stroke Rehabilitation and Recovery

Abstract Objective To evaluate the efficacy of a clinical decision support system (CDSS) on stroke care quality and clinical outcomes among patients with acute ischaemic stroke. Design Multicentre, cluster randomised clinical trial. Setting 77 hospitals across China. Participants 77 hospitals (38 randomised to intervention group, 39 to control group) enrolled 21 603 patients with acute ischaemic stroke admitted to hospital within seven days after symptom onset. Interventions Hospitals in the intervention group received stroke CDSS support including artificial intelligence assisted imaging analysis, classification of stroke causes, and evidence based treatment recommendations. Hospitals in the control group provided usual care. Main outcomes measures The primary outcome was a new vascular event (composite of ischaemic stroke, haemorrhagic stroke, myocardial infarction, and vascular death) within three months after initial symptom onset. Secondary outcomes included the composite measure and all-or-none measure of evidence based performance measures for acute ischaemic stroke care quality, a new vascular event at six and 12 months, and disability (modified Rankin Scale score 3-6) and all cause mortality at three, six, and 12 months. Safety outcomes were moderate or severe bleeding events and all bleeding events at three, six, and 12 months. Results 11 054 patients in the intervention group and 10 549 patients in the control group were enrolled from January 2021 to June 2023. New...