Clinical Decision Support for Patients Presenting With Large Vessel Occlusion.

Area of Science:

• Neurology
• Clinical Trials
• Health Informatics

Background:

• Acute ischemic stroke due to large vessel occlusions (LVOs) requires timely and specialized treatment.
• Implementing new clinical trials for LVOs presents logistical and clinical decision-making challenges.

Purpose of the Study:

• To describe the development of a multidisciplinary clinical decision support tool for implementing acute ischemic stroke trials.
• To create a process map for guiding patient selection for endovascular therapy in LVO cases.

Main Methods:

• A collaborative, multidisciplinary review was conducted at a single center.
• A flow diagram process map was developed and integrated into the electronic health record (EHR).
• Patients were stratified into four groups based on infarct size and presentation time.

Main Results:

• The process map provides clinical decision support for selecting patients for endovascular therapy using neuroimaging.
• Guidance is offered for patient and family discussions regarding treatment options for LVOs with varying infarct sizes.
• The manuscript details the creation process, including addressing points of controversy.

Conclusions:

• A multidisciplinary approach can effectively create a valuable clinical decision support tool for LVO stroke trials.
• The developed process map enhances patient care by standardizing decision-making for endovascular therapy.
• This tool facilitates informed discussions and improves the implementation of acute ischemic stroke interventions.