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Rationale and design of the GOLDEN BRIDGE II: a cluster-randomised multifaceted intervention trial of an artificial intelligence-based cerebrovascular disease clinical decision support system to improve stroke outcomes and care quality in China

Zixiao Li, Xinmiao Zhang, Lingling Ding, Jing Jing, Hong-Qiu Gu, Yong Jiang, Xia Meng, Chunying Du, Chunjuan Wang, Meng Wang, Man Xu, Yanxu Zhang, Meera Hu, Hao Li, Xiping Gong, Kehui Dong, Xingquan Zhao, Yilong Wang, Liping Liu, Ying Xian, Eric Peterson, Gregg C Fonarow, Lee H Schwamm, Yongjun Wang
DOI: 10.1136/svn-2023-002411 Published 30 December 2024
Zixiao Li
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
3 Chinese Institute for Brain Research, Beijing, China
4 Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
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Xinmiao Zhang
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Lingling Ding
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Jing Jing
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Hong-Qiu Gu
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yong Jiang
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Xia Meng
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Chunying Du
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Chunjuan Wang
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Meng Wang
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Man Xu
5 Hanalytics Artificial Intelligence Research Centre for Neurological Disorders, China National Clinical Research Center for Neurological Diseases, Beijing, China
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Yanxu Zhang
5 Hanalytics Artificial Intelligence Research Centre for Neurological Disorders, China National Clinical Research Center for Neurological Diseases, Beijing, China
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Meera Hu
5 Hanalytics Artificial Intelligence Research Centre for Neurological Disorders, China National Clinical Research Center for Neurological Diseases, Beijing, China
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Hao Li
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Xiping Gong
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Kehui Dong
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Xingquan Zhao
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
4 Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
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Yilong Wang
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Liping Liu
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
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Ying Xian
6 Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Eric Peterson
7 Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Gregg C Fonarow
8 Cardiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
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Lee H Schwamm
9 Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Yongjun Wang
1 Department of Neurology, Beijing Tiantan Hospital, Beijing, China
2 China National Clinical Research Center for Neurological Diseases, Beijing, China
4 Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
10 Clinical Center for Precision Medicine in Stroke, Capital Medical Universit, Beijing, China
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    Figure 1

    The flow chart of this study. AI-CDSS, artificial intelligence-based clinical decision support system.

  • Figure 2
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    Figure 2

    The framework for cerebrovascular disease clinical decision support system (CDSS). EMR, Electronic Medical Record; HIS, Hospital Information System; LIS, Laboratory Information Management System; PACS, Picture Archiving and Communication System; TOAST, Trial of Org 10172 in Acute Stroke Treatment; CISS, Chinese Ischemic Stroke Subclassification.

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    Figure 3

    Intervention flow chart. CDSS, clinical decision support system.

Tables

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  • Table 1

    The inclusion and exclusion criteria for the hospitals

    Inclusion criteriaExclusion criteria
    1. Tertiary-grade or secondary-grade hospitals1. Primary-grade (ie, community) hospitals
    2. Consisting of emergency department and neurological wards for patients who had a stroke2. <20 patients who had an acute ischaemic stroke admitted per month
    3. Consisting of 1.5T or 3T MRI machine with the functionalities for completing DWI and MRA scan3. Specialised hospitals (cancer hospitals, maternity hospitals, children’s hospitals, etc)
    • DWI, diffusion weighted imaging.

  • Table 2

    The inclusion and exclusion criteria for the participants

    Inclusion criteriaExclusion criteria
    1. Older than 18 years1. Negative ischaemic stroke on DWI or transient ischaemic attack
    2. Ischaemic stroke within 7 days of symptom onset2. Diagnosis of other cerebrovascular diseases (cerebral haemorrhage, subarachnoid haemorrhage, cerebral venous sinus thrombosis, etc)
    3. Ischaemic stroke confirmed by imaging of the brain3. Diagnosis of other diseases (epilepsy, central nervous system infection, metabolic encephalopathy, etc)
    4. Hospitalisation from emergency or outpatient department4. Pregnancy or delivery within the 6 weeks before the study
    5. Participants or their legal guardians give their permission to conduct the study by signing an informed consent5. Participation in other pharmaceutical or device-based interventional studies
    6. With terminal diseases (life expectancy<3 months) or cannot commit to completing the study due to other reasons
    • DWI, diffusion weighted imaging.

Supplementary Materials

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  • Supplementary data

    [svn-2023-002411supp001.pdf]

Additional Files

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  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    • Data supplement 1
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Rationale and design of the GOLDEN BRIDGE II: a cluster-randomised multifaceted intervention trial of an artificial intelligence-based cerebrovascular disease clinical decision support system to improve stroke outcomes and care quality in China
Zixiao Li, Xinmiao Zhang, Lingling Ding, Jing Jing, Hong-Qiu Gu, Yong Jiang, Xia Meng, Chunying Du, Chunjuan Wang, Meng Wang, Man Xu, Yanxu Zhang, Meera Hu, Hao Li, Xiping Gong, Kehui Dong, Xingquan Zhao, Yilong Wang, Liping Liu, Ying Xian, Eric Peterson, Gregg C Fonarow, Lee H Schwamm, Yongjun Wang
Stroke and Vascular Neurology Dec 2024, 9 (6) 723-729; DOI: 10.1136/svn-2023-002411

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Rationale and design of the GOLDEN BRIDGE II: a cluster-randomised multifaceted intervention trial of an artificial intelligence-based cerebrovascular disease clinical decision support system to improve stroke outcomes and care quality in China
Zixiao Li, Xinmiao Zhang, Lingling Ding, Jing Jing, Hong-Qiu Gu, Yong Jiang, Xia Meng, Chunying Du, Chunjuan Wang, Meng Wang, Man Xu, Yanxu Zhang, Meera Hu, Hao Li, Xiping Gong, Kehui Dong, Xingquan Zhao, Yilong Wang, Liping Liu, Ying Xian, Eric Peterson, Gregg C Fonarow, Lee H Schwamm, Yongjun Wang
Stroke and Vascular Neurology Dec 2024, 9 (6) 723-729; DOI: 10.1136/svn-2023-002411
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Rationale and design of the GOLDEN BRIDGE II: a cluster-randomised multifaceted intervention trial of an artificial intelligence-based cerebrovascular disease clinical decision support system to improve stroke outcomes and care quality in China
Zixiao Li, Xinmiao Zhang, Lingling Ding, Jing Jing, Hong-Qiu Gu, Yong Jiang, Xia Meng, Chunying Du, Chunjuan Wang, Meng Wang, Man Xu, Yanxu Zhang, Meera Hu, Hao Li, Xiping Gong, Kehui Dong, Xingquan Zhao, Yilong Wang, Liping Liu, Ying Xian, Eric Peterson, Gregg C Fonarow, Lee H Schwamm, Yongjun Wang
Stroke and Vascular Neurology Dec 2024, 9 (6) 723-729; DOI: 10.1136/svn-2023-002411
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