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NCT Number: NCT07626229

Domain-Specific Large Language Model Assistance for Emergency Neurological Diagnosis and Treatment(DEMAND)

This study will evaluate whether Xuanwu-NeuroAid 2.0, a large language model for emergency neurology, can improve 30-day diagnostic quality in adults with acute neurological symptoms. Physicians will be randomly assigned to AI-assisted care or usual care. In the AI-assisted group, the model will provide diagnostic and management suggestions, while physicians will make all final clinical decisions. The usual-care group will receive standard emergency neurology care without large language model assistance.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Nanyang Nanshi Hospital, Nanyang, Henan, China

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About this study

This multicenter, prospective, cluster randomized trial will evaluate whether Xuanwu-NeuroAid 2.0, a domain-specific large language model for emergency neurology, can improve diagnostic quality in adults presenting with acute neurological symptoms. Physicians will be randomized to AI-assisted care or usual care. In the AI-assisted group, the model will provide diagnostic and management suggestions based on available clinical information, while physicians will remain responsible for all final clinical decisions. the model's recommendations could be disregarded when they were considered inappropriate. The usual-care group will receive standard emergency neurology care without large language model assistance.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age ≥18 years;
  • Presentation to the emergency neurology service with acute neurological symptoms;
  • Written informed consent provided by the patient or a legally authorized representative.

Exclusion criteria

  • Presentation primarily for trauma;
  • Pregnancy;
  • Requiring immediate life-saving interventions;
  • Estimated life expectancy of less than 30 days;
  • Participation in another clinical trial within the previous 30 days or in a trial that could interfere with the study or outcome assessment;
  • Any condition that, in the opinion of the investigators, would interfere with the conduct of the trial or the interpretation of the results.

Treatment and study plan

Xuanwu-NeuroAid 2.0

Device

Xuanwu-NeuroAid 2.0 is a large language model used to support emergency neurology evaluation and management. It generates diagnostic and management suggestions based on available clinical information, including history, physical examination, laboratory results, and imaging data. Physicians may interact with the model multiple times, but remain responsible for all final clinical decisions. Its recommendations may be overridden when considered inappropriate.

Primary outcomes

  1. Diagnostic-care quality risk

    Time frame: Day 30

    A composite outcome defined as the occurrence of any of the following: a diagnostic discrepancy within 30 days; unplanned medical care within 30 days; harms related to the index emergency care within 30 days; or all-cause death within 30 days.

Secondary outcomes

  1. Diagnostic discrepancy

    Time frame: Day 30

    Diagnostic discrepancy is defined as disagreement between the emergency department final diagnosis and the 30-day expert-adjudicated reference diagnosis.

  2. Quality of diagnostic testing and management recommendations

    Time frame: Day 30

    The quality of diagnostic testing and management recommendations made during the index emergency department encounter will be assessed by blinded expert adjudicators after completion of 30-day follow-up, using a 5-point Likert scale. Higher scores indicate higher quality of diagnostic testing and management recommendations.

  3. Patient satisfaction with emergency care

    Time frame: Immediately after the index emergency department encounter, within 48 hours

    Patient satisfaction with emergency care will be assessed after the index emergency department encounter using a 5-point Likert scale, ranging from 1 to 5, with higher scores indicating greater satisfaction.

  4. Time spent per patient encounter

    Time frame: Time from start of physician evaluation to completion of final diagnosis and disposition decision, within 48 hours.

    Time spent per patient encounter is defined as the duration from the start of physician evaluation to completion of the emergency department final diagnosis and disposition decision during the index emergency department encounter.

  5. Clinician-reported workload

    Time frame: Immediately after each index emergency department encounter, within 48 hours.

    Clinician-reported workload will be assessed by the treating physician using a single-item 5-point Likert scale, ranging from 1 to 5. Higher scores indicate greater perceived workload.

  6. EQ-5D-5L at 30 days

    Time frame: Day 30

    Health-related quality of life will be assessed using the EuroQol five-dimension five-level questionnaire. The EQ-5D-5L utility index score will be derived according to the applicable value set. The maximum score is 1, indicating full health; higher scores indicate better health status.

Other outcomes

  1. Unplanned medical care within 30 days

    Time frame: From completion of the index emergency department encounter to Day 30

    Unplanned medical care is defined as any unscheduled emergency department visit, outpatient visit, or hospital admission within 30 days after the index emergency department encounter.

  2. Harms related to this emergency care within 30 days

    Time frame: From completion of the index emergency department encounter to Day 30

    Harms are defined as adverse clinical events within 30 days after the index emergency department encounter.

  3. All-cause death within 30 days

    Time frame: From completion of the index emergency department encounter to Day 30

    All-cause death is defined as death from any cause within 30 days after the index emergency department encounter.

Sponsors and collaborators

Lead sponsor

Capital Medical University

Other

Registry information

Official study title

Domain-Specific Large Language Model Assistance for Emergency Neurological Diagnosis and Treatment: A Randomized Controlled Clinical Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 4, 2026
Registry last updated
Jul 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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