ArticleBMC medical informatics and decision making2015
Development of a computerised decision aid for thrombolysis in acute stroke care.
Article in BMC medical informatics and decision making, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Facilitators and Barriers of the Use of Prognostic Models for Clinical Decision Making in Acute Neurologic Care: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Pooled it
- Stakeholder Perspectives of Clinical Artificial Intelligence Implementation: Systematic Review of Qualitative Evidence.Journal of medical Internet research · 2023Pooled it
- Article
- A study on factors influencing decision - making conflicts of proxies of thrombolytic patients with acute ischemic stroke: a network analysis.BMC medical informatics and decision making · 2025Article
- Challenges in the Literature Around Context-Sensitive Implementation of Shared Decision Making in Emergency Medicine: A Scoping Review.Open access emergency medicine : OAEM · 2025Review
- 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.Stroke and vascular neurology · 2024Article
- Systematic review to understand users perspectives on AI-enabled decision aids to inform shared decision making.NPJ digital medicine · 2024Article
- Stroke survivor views on ambulance redirection as a strategy to increase access to thrombectomy in England.British paramedic journal · 2024Article
- Road map for clinicians to develop and evaluate AI predictive models to inform clinical decision-making.BMJ health & care informatics · 2023Review
- Identifying barriers and facilitators to successful implementation of computerized clinical decision support systems in hospitals: a NASSS framework-informed scoping review.Implementation science : IS · 2023Article
- Ability of patients with acute ischemic stroke to recall given information on intravenous thrombolysis: Results of a prospective multicenter study.European stroke journal · 2023Observational
- Acute stroke CDS: automatic retrieval of thrombolysis contraindications from unstructured clinical letters.Frontiers in digital health · 2023Article
- Development of a patient decision aid for discharge planning of hospitalized patients with stroke.BMC neurology · 2022Article
- Clinicians' perspectives on the implementation of patient decision aids in the emergency department: A qualitative interview study.Journal of the American College of Emergency Physicians open · 2022Article
- Risky business: a scoping review for communicating results of predictive models between providers and patients.JAMIA open · 2021Article
- Palliative care after stroke: A review.International journal of stroke : official journal of the International Stroke Society · 2021Review
- Availability and use of number needed to treat (NNT) based decision aids for pharmaceutical interventions.Exploratory research in clinical and social pharmacy · 2021Review
- Decision-Making Visual Aids for Late, Imaging-Guided Endovascular Thrombectomy for Acute Ischemic Stroke.Journal of stroke · 2020Article
- Long-Term Survival After Stroke According to Reperfusion Therapy, Cardiovascular Therapy and Gender.Cardiology research · 2019Article
- A novel design process for selection of attributes for inclusion in discrete choice experiments: case study exploring variation in clinical decision-making about thrombolysis in the treatment of acute ischaemic stroke.BMC health services research · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThrombolytic treatment for acute ischaemic stroke improves prognosis, although there is a risk of bleeding complications leading to early death/severe disability. Benefit from thrombolysis is time dependent and treatment must be administered within 4.5 hours from onset of symptoms, which presents unique challenges for development of tools to support decision making and patient understanding about treatment. Our aim was to develop a decision aid to support patient-specific clinical decision-making about thrombolysis for acute ischaemic stroke, and clinical communication of personalised information on benefits/risks of thrombolysis by clinicians to patients/relatives.
methodsUsing mixed methods we developed a COMPuterised decision Aid for Stroke thrombolysiS (COMPASS) in an iterative staged process (review of available tools; a decision analytic model; interactive group workshops with clinicians and patients/relatives; and prototype usability testing). We then tested the tool in simulated situations with final testing in real life stroke thrombolysis decisions in hospitals. Clinicians used COMPASS pragmatically in managing acute stroke patients potentially eligible for thrombolysis; their experience was assessed using self-completion forms and interviews. Computer logged data assessed time in use, and utilisation of graphical risk presentations and additional features. Patients'/relatives' experiences of discussions supported by COMPASS were explored using interviews.
resultsCOMPASS expresses predicted outcomes (bleeding complications, death, and extent of disability) with and without thrombolysis, presented numerically (percentages and natural frequencies) and graphically (pictographs, bar graphs and flowcharts). COMPASS was used for 25 patients and no adverse effects of use were reported. Median time in use was 2.8 minutes. Graphical risk presentations were shared with 14 patients/relatives. Clinicians (n = 10) valued the patient-specific predictions of benefit from thrombolysis, and the support of better risk communication with patients/relatives. Patients (n = 2) and relatives (n = 6) reported that graphical risk presentations facilitated understanding of benefits/risks of thrombolysis. Additional features (e.g. dosage calculator) were suggested and subsequently embedded within COMPASS to enhance usability.
conclusionsOur structured development process led to the development of a gamma prototype computerised decision aid. Initial evaluation has demonstrated reasonable acceptability of COMPASS amongst patients, relatives and clinicians. The impact of COMPASS on clinical outcomes requires wider prospective evaluation in clinical settings.
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