Evidence map›Paper›PMID 42843886›Full record

Observational studyBMJ open2026

Real-time prospective (shadow mode) validation of an AI-based clinical decision support system for predicting 3-month functional outcome in acute stroke: the VALIDATE study protocol.

Marta Rubiera, Martin Bendszus, Ronen R Leker, Adam Hilbert, Ingo Werren, Luis Miguel Lopez-Ramos, Mercedes Ayesta, Que Nguyen, Sussane Bonekamp, Victoria Sala and 9 more

Registry-linked trialAbstract readMulticenter StudyObservational StudyValidation Study
In one paragraph

Observational study in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05622539 (Validation of a Trustworthy AI-based Clinical Decision Support System for Improving Patient Outcome in Acute Stroke Treatment), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT05622539 completednot on this map

Validation of a Trustworthy AI-based Clinical Decision Support System for Improving Patient Outcome in Acute Stroke Treatment

TypeobservationalSponsorHospital Universitari Vall d'Hebron Research InstituteRan2024 to 2026Enrolled289ConditionsAcute StrokeArmsCONVENTIONAL ACUTE STROKE MANAGEMENT
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Marta RubieraStroke Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain mrubifu@hotmail.com.ORCID http://orcid.org/0000-0001-8100-9477
Martin Bendszus *Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.
Ronen R Leker *Department of Neurology, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
Adam HilbertCharité Lab for Artificial Intelligence in Medicine (CLAIM), Charité - Universitätsmedizin Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0003-3447-5453
Ingo WerrenDigital Health Department, IBM iX GmbH, Berlin, Germany.
Luis Miguel Lopez-RamosSimula Metropolitan Center for Digital Engineering AS, Oslo, Norway.ORCID http://orcid.org/0000-0001-8072-3994
Mercedes AyestaNORA Health, Sant Cugat, Spain.
Que NguyenTechnological University Dublin, Dublin, Ireland.
Sussane BonekampDepartment of Neuroradiology, University of Heidelberg, Heidelberg, Germany.ORCID http://orcid.org/0000-0001-9681-5973
Victoria SalaStroke Research Group, Vall d'Hebron Institut de Recerca, Barcelona, Spain.
Hamza JubranDepartment of Neurology, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
Claudia MezaStroke Research Group, Vall d'Hebron Institut de Recerca, Barcelona, Spain.
Fatma ShalabiDepartment of Neurology, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
Yoel SchwartzmannDepartment of Neurology, Hebrew University Hadassah Medical School, Yerushalayim, Israel.
David CanoNORA Health, Sant Cugat, Spain.
Malte von TottlebenDigital Health, Empirica Gesellschaft für Kommunikations- und Technologieforschung mbH, Bonn, Germany.
John KelleherADAPT Research Centre, School of Computer Science and Statistics, Trinity College, Dublin, Ireland.
Dietmar FreyCharité Lab for Artificial Intelligence in Medicine (CLAIM), Charité - Universitätsmedizin Berlin, Berlin, Germany.
VALIDATE investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionReperfusion therapies improve outcomes in acute ischaemic stroke, but hyperacute treatment decisions remain complex and are rarely informed by individualised outcome predictions. Artificial intelligence (AI)-based clinical decision support systems (CDSS) could provide real-time prognostic estimates, yet prospective evidence of their feasibility and performance within routine workflows is scarce. We aim to prospectively evaluate the real-time feasibility, usability and predictive performance of an AI-based CDSS (VALIDATE-CDSS) for individualised outcome prediction in acute stroke care. METHODS AND ANALYSIS: Prospective, multicentre observational study enrolling consecutive patients with acute ischaemic stroke at three tertiary stroke centres. Clinical management will follow standard practice at the discretion of treating physicians. In parallel, a dedicated researcher will collect patient data in real time and enter them into VALIDATE-CDSS via a mobile application, operating in shadow mode without influencing clinical decisions. The system will generate individualised predictions of 3-month functional outcome (modified Rankin Scale) for four treatment strategies (intravenous thrombolysis, endovascular thrombectomy, combined therapy or no reperfusion) at three sequential time points: baseline clinical data, non-contrast CT and CT angiography. The primary outcome is the real-world feasibility and usability of VALIDATE-CDSS within the hyperacute stroke workflow. Secondary outcomes include predictive performance, agreement between model-suggested and actual treatments, incremental value with increasing data availability and potential bias across predefined subgroups. ETHICS AND DISSEMINATION: Enrolment began after approval by the ethics committees of all participating centres (Vall d'Hebron Institut de Recerca, PR(AG)432-2023; Ethikkommission der Medizinischen Fakultät Heidelberg, S-687/2023; Helsinki Committee, Hadassah Medical Center-Ein Kerem, HMO-0529-22). Results will be disseminated through peer-reviewed open-access journals and conference presentations. Following open science principles, anonymised data and metadata will be deposited in the Zenodo repository on study completion. TRIAL REGISTRATION NUMBER: NCT05622539.

Indexed as

Artificial IntelligenceDecision Support Systems, ClinicalIschemic StrokeStrokeFeasibility StudiesFemaleHumansPrognosisProspective StudiesResearch DesignThrombolytic TherapyTreatment OutcomeArtificial IntelligenceStrokeTreatment Outcome

Identifiers

PMID42843886
PMCPMC13647027

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.