Stroke Unit, University Hospital of Strasbourg, Strasbourg, France.
INSERM U1119 Myelin Biopathology, Neuroprotection, and Therapeutic Strategies, Strasbourg, France.
J Neurol. 2023 Dec;270(12):6113-6123. doi: 10.1007/s00415-023-11979-6. Epub 2023 Sep 5.
Acute ischemic stroke (AIS) is an immediate emergency whose management is becoming more and more personalized while facing a limited number of neurologists with high expertise. Clinical decision support systems (CDSS) are digital tools leveraging information and artificial intelligence technologies. Here, we present the Strokecopilot project, a CDSS for the management of the acute phase of AIS. It has been designed to support the evidence-based medicine reasoning of neurologists regarding the indications of intravenous thrombolysis (IVT) and endovascular treatments (ET).
Reference populations were manually extracted from the field's main guidelines and randomized clinical trials (RCT). Their characteristics were harmonized in a computerized reference database. We developed a web application whose algorithm identifies the reference populations matching the patient's characteristics. It returns the latter's outcomes in a graphical user interface (GUI), whose design has been driven by real-world practices.
Strokecopilot has been released at www.digitalneurology.net . The reference database includes 25 reference populations from 2 guidelines and 15 RCTs. After a request, the reference populations matching the patient characteristics are displayed with a summary and a meta-analysis of their results. The status regarding IVT and ET indications are presented as "in guidelines", "in literature", or "outside literature references". The GUI is updated to provide several levels of explanation. Strokecopilot may be updated as the literature evolves by loading a new version of the reference populations' database.
Strokecopilot is a literature-based CDSS, developed to support neurologists in the management of the acute phase of AIS.
急性缺血性脑卒中（AIS）是一种紧急情况，其管理越来越个性化，而具有高专业知识的神经科医生数量有限。临床决策支持系统（CDSS）是利用信息和人工智能技术的数字工具。在这里，我们介绍了 Strokecopilot 项目，这是一种用于管理 AIS 急性期的 CDSS。它旨在支持神经科医生在静脉溶栓（IVT）和血管内治疗（ET）适应证方面的循证医学推理。
参考人群是从该领域的主要指南和随机对照试验（RCT）中手动提取的。他们的特征在计算机参考数据库中得到了协调。我们开发了一个 Web 应用程序，其算法可以识别与患者特征匹配的参考人群。它在图形用户界面（GUI）中返回后者的结果，其设计受到实际实践的驱动。
Strokecopilot 已在 www.digitalneurology.net 上发布。参考数据库包括 2 项指南和 15 项 RCT 中的 25 个参考人群。在请求后，与患者特征匹配的参考人群将以摘要和对其结果的荟萃分析显示。IVT 和 ET 适应证的状态显示为“在指南中”、“在文献中”或“在文献参考之外”。GUI 会更新以提供多个级别的解释。通过加载参考人群数据库的新版本，Strokecopilot 可以随着文献的发展而更新。
Strokecopilot 是一种基于文献的 CDSS，旨在支持神经科医生管理 AIS 的急性期。
