IDEAL Study: Blinded RCT for the Impact of AI Model for Cerebral Aneurysms Detection on Patients' Diagnosis and Outcomes (IDEAL)
Assessing the Impact of an Artificial Intelligence-Based Model for Intracranial Aneurysm Detection in CT Angiography on Patients' Diagnosis and Outcomes: The IDEAL Study - A Web-Based Multicenter, Double-Blinded Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Longjiang Zhang, MD
- Phone Number: +8613405833176
- Email: kevinzhlj@163.com
Study Locations
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Haikou, China
- Recruiting
- Hainan General Hospital
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Contact:
- Chen
- Phone Number: 86-13876901502
- Email: fenger0802@163.com
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Kashgar, China
- Recruiting
- The First People's Hospital of Kashgar Region
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Contact:
- Nijiati
- Phone Number: 86-13565662557
- Email: mydl0911@163.com
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Lanzhou, China
- Recruiting
- University Second Hospital
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Contact:
- Zhou
- Phone Number: 86-15193107916
- Email: zjl601@163.com
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Lianyungang, China
- Recruiting
- First People's Hospital of Lianyungang
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Contact:
- Gu
- Phone Number: 86-13815617997
- Email: guyan2020@njmu.edu.cn
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Ma’anshan, China
- Recruiting
- Ma'anshan People's Hospital
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Contact:
- Yang
- Phone Number: 86-13365557527
- Email: yanghk1979@163.com
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Nanjing, China
- Recruiting
- BenQ Medical Center, Affiliated BenQ Hospital of Medical School, Nanjing Medical University
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Contact:
- Zhou
- Phone Number: 86-13813951215
- Email: daniezhou@126.com
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Shenzhen, China
- Recruiting
- Long Gang Central Hospital of Shenzhen
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Contact:
- Zhang
- Phone Number: 86-18026971278
- Email: 18819818005@163.com
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Suqian, China
- Recruiting
- The Affiliated Suqian First Hospital of Nanjing Medical University
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Contact:
- Xu
- Phone Number: 86-18012186660
- Email: keyisq@163.com
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Tianjin, China
- Recruiting
- Tianjin Medical University General Hospital
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Contact:
- Wang
- Phone Number: 86-13820976417
- Email: wangjunping_tj@163.com
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Yinchuan, China
- Recruiting
- General Hospital of Ningxia Medical University
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Contact:
- Wang
- Phone Number: 86-13995109434
- Email: xdw80@yeah.net
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Anhui
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Hefei, Anhui, China
- Recruiting
- The First Affiliated Hospital of University of Science and Technology of China
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Contact:
- Wei
- Phone Number: 86-13856005207
- Email: weiweill@126.com
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Wuhu, Anhui, China
- Recruiting
- The First Affiliated Hospital of Wannan Medical College
-
Contact:
- Zhou
- Phone Number: 86-18110876440
- Email: zhouyunfeng808@163.com
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-
Guizhou
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Guiyang, Guizhou, China
- Recruiting
- Guizhou Provincial People's Hospital
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Contact:
- Wang
- Phone Number: 86-18685193598
- Email: wangrongpin@126.com
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Henan
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Zhengzhou, Henan, China
- Recruiting
- First Affiliated Hospital of Zhengzhou University
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Contact:
- Zhang
- Phone Number: 86-13673663923
- Email: zyg01578@126.com
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Hubei
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Shiyan, Hubei, China
- Recruiting
- Shiyan People's Hospital
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Contact:
- Li
- Phone Number: 86-13597909005
- Email: lish1981@126.com
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Jiangsu
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Nanjing, Jiangsu, China, 210018
- Recruiting
- Research Institute Of Medical Imaging Jinling Hospital
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Contact:
- Longjiang Zhang, MD
- Phone Number: 13405833176
- Email: kevinzhlj@163.com
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Xuzhou, Jiangsu, China
- Recruiting
- Affiliated Hospital of Xuzhou Medical University
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Contact:
- Hu
- Phone Number: 86-15262038898
- Email: hcfxz@163.com
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Jilin
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Changchun, Jilin, China
- Recruiting
- The First Hospital of Jilin University
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Contact:
- Zhang
- Phone Number: 86-13843109555
- Email: huimao@jlu.edu.cn
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Shandong
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Jinan, Shandong, China
- Recruiting
- Shandong Provincial Hospital Affiliated to Shandong First Medical University
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Contact:
- Wang
- Phone Number: 86-15168886672
- Email: wxming369@163.com
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Weifang, Shandong, China
- Recruiting
- Yidu Central Hospital Affiliated to Shandong Second Medical University
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Contact:
- Feng
- Phone Number: 86-13562606690
- Email: fengqiang220812@163.com
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Yunnan
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Kunming, Yunnan, China
- Recruiting
- The First Affiliated Hospital of Kunming Medical University
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Contact:
- He
- Phone Number: 86-13888967549
- Email: kmmu_hb@163.com
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult inpatients and outpatients who are scheduled for head CTA scanning.
Exclusion Criteria:
- Age under 18 years.
- Patients with contraindications to CTA.
- Modified Rankin Scale (mRS) score > 3.
- Refuse to sign informed consent.
- Participation in other clinical studies of intracranial aneurysms.
- Patients with failed head CTA scanning or incomplete image data, or poor image quality.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: True-AI-integrated intracranial aneurysms diagnosis strategy
For patients who underwent head CTA and assigned to True-AI group, they will be diagnosed by a radiologist who are aided by the True-AI-integrated intracranial aneurysms diagnosis strategy.
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The True-AI deep-learning based model for intracranial aneurysms detection had a patient-wise sensitivity, lesion-wise sensitivity and specificity of 0.96, 0.87, and 0.80 in the internal validation dataset.
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Sham Comparator: Sham-AI-integrated intracranial aneurysms diagnosis strategy
For patients who underwent head CTA and assigned to Sham-AI group, they will be diagnosed by a radiologist who are aided by the Sham-AI-integrated intracranial aneurysms diagnosis strategy.
To mimic the True-AI, the Sham-AI had a sensitivity close to 0% and a similar specificity to the True-AI.
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The Sham-AI deep-learning based model for intracranial aneurysms detection is designed to have a sensitivity close to 0% and a similar specificity to the True-AI.
In the internal validation dataset, the Sham-AI had a patient-wise sensitivity, lesion-wise sensitivity, specificity of 0.02, 0.01, and 0.80, respectively.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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To compare diagnostic sensitivity of intracrnial aneurysms between intervention and control arm.
Time Frame: 6 months.
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The proportion of examinations in which at least one aneurysm is discovered and indicated among groundtruth aneurysms.
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6 months.
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To compare diagnostic specificity of intracrnial aneurysms between intervention and control arm.
Time Frame: 6 months.
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The proportion of examinations in which no aneurysms are spotted by the reader among groundtruth non-aneurysms.
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6 months.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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To compare other diagnostic performances for intracranial aneurysms between intervention and control arm.
Time Frame: 6 months.
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To compare accuracy, lesion-wise sensitivity, positive predictive value and negative predictive value for intracranial aneurysms between intervention and control arm.
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6 months.
|
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To compare diagnostic performances for other intracranial lesions between intervention and control arm.
Time Frame: 6 months.
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The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for intracranial arterial stenosis, occlusion, and intracranial tumors are compared between intervention and control arm.
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6 months.
|
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To compare detection rates of intracranial lesions according to Radiology Reports between intervention and control arm.
Time Frame: 6 months.
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Detection rates of intracranial aneurysms, intracranial arterial stenosis, occlusion, and intracranial tumors according to Radiology Reports are compared between intervention and control arm.
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6 months.
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To assess the workload of head CT angiography interpretation.
Time Frame: 6 months.
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Time of interpreting head CT angiography images, number of consensus meeting are compared between intervention and control arm.
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6 months.
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To assess resource use.
Time Frame: At 3-month and 12-month follow-up.
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The number of care encounters (in-person) during follow-up, total number of outpatient encounters for aneurysm referral, total number of cerebral artery disease testing are compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rate of patients of subsequent hospitalization during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Rate of patients of subsequent hospitalization is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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In-hospital mortality rate during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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In-hospital mortality rate is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Morbidity (modified Rankin Score ≥ 3) from intracranial haemorrhage or treatment during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Morbidity (modified Rankin Score ≥ 3) from intracranial haemorrhage or treatment is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Length of hospital stay during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Length of hospital stay is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rate of hospitalization for intracranial aneurysms during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Rate of hospitalization for intracranial aneurysms is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rate of patients undergoing digital subtraction angiography (DSA) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Rate of patients undergoing digital subtraction angiography (DSA) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Detection rate of intracranial aneurysms among digital subtraction angiographys (DSA) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Detection rate of intracranial aneurysms among digital subtraction angiographys (DSA) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Detection rate of no abnormality among digital subtraction angiographys (DSA) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Detection rate of no abnormality among digital subtraction angiographys (DSA) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Distribution of the methods for aneurysms management (conservative/coil/clip/others) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Distribution of the methods for aneurysms management (conservative/coil/clip/others) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rates of aneurysm treatment related complications during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Rate of aneurysm treatment related complications (intraoperative rupture, stroke, et al) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rate of recurrence or residual of intracranial aneurysm after surgery during patient follow-up.
Time Frame: At 12-month follow-up.
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Rate of recurrence or residual of intracranial aneurysm after surgery is compared between intervention and control arm.
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At 12-month follow-up.
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Life quality assessed by EuroQol 5-Dimensional, 5-Level (EQ-5D-5L) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Life quality assessed by EuroQol 5-Dimensional, 5-Level (EQ-5D-5L) scores are compared between intervention and control arm, which ranges from 5 to 25, and higher scores mean a worse outcome.
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At 3-month and 12-month follow-up.
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Restrictions in daily activities assessed by Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) scores during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Restrictions in daily activities assessed by Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) scores are compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Sleep quality assessed by Pittsburgh Sleep Quality Index (PSQI) is compared between intervention and control arm, which ranges from 0 to 21, and higher scores mean a worse outcome.
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At 3-month and 12-month follow-up.
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Depression Screening assessed by Patient Health Questionnaire-9 (PHQ-9) scores during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Depression Screening assessed by Patient Health Questionnaire-9 (PHQ-9) scores are compared between intervention and control arm, which ranges from 0 to 27, and higher scores mean a worse outcome.
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At 3-month and 12-month follow-up.
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Anxiety and depression assessed by Hospital Anxiety and Depression Scale (HADS) scores during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Anxiety and depression assessed by Hospital Anxiety and Depression Scale (HADS) scores are compared between intervention and control arm, which ranges from 0 to 21, and higher scores mean a worse outcome.
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At 3-month and 12-month follow-up.
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General health assessed by Short-Form 36 Health Survey (SF-36) scores during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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General health assessed by Short-Form 36 Health Survey (SF-36) scores are compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Functional outcome assessed by Modified Rankin Scale (mRS) scores during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Functional outcome assessed by Modified Rankin Scale (mRS) scores are compared between intervention and control arm, which ranges from 0 to 5, and higher scores mean a worse outcome.
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At 3-month and 12-month follow-up.
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All-cause mortality during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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All-cause mortality is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rate of aneurysm growth during patient follow-up.
Time Frame: At 12-month follow-up.
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Rate of aneurysm growth is compared between intervention and control arm.
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At 12-month follow-up.
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Rate of aneurysm rupture during patient follow-up.
Time Frame: At 12-month follow-up.
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Rate of aneurysm rupture is compared between intervention and control arm.
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At 12-month follow-up.
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Rate of subarachnoid hemorrhage (SAH) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Rate of subarachnoid hemorrhage (SAH) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Rate of other types of stroke (hemorrhagic stroke, ischemic stroke) during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Rate of other types of stroke (hemorrhagic stroke, ischemic stroke) is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Mortality of aneurysms-rupture during patient follow-up.
Time Frame: At 3-month and 12-month follow-up.
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Mortality of aneurysms-rupture is compared between intervention and control arm.
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At 3-month and 12-month follow-up.
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Morphological change by head CTA or magnetic resonance angiography at the 12-month follow-up.
Time Frame: At 12-month follow-up.
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Morphological change by head CTA or magnetic resonance angiography is assessed.
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At 12-month follow-up.
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Patient-wise sensitivity and specificity at different centers, provinces, geography areas and levels of physician.
Time Frame: 6 months.
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To compare diagnostic performances of patient-wise sensitivity and specificity for intracranial aneurysms between intervention and control arm in subgroups of different centers, provinces, geography areas and physician level.
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6 months.
|
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Subgroup analysis of different size (< 5 mm vs. ≥ 5 mm), locations of intracranial aneurysms.
Time Frame: 6 months.
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To compare diagnostic performances for intracranial aneurysms between intervention and control arm in subgroups of different size (internal carotid artery vs. middle cerebral artery vs. anterior cerebral artery vs. posterior communication artery vs. anterior communication artery vs. vertebral basilar artery vs. others), locations (internal carotid artery vs. middle cerebral artery vs. anterior cerebral artery vs. posterior communication artery vs. anterior communication artery vs. vertebral basilar artery vs. others) of intracranial aneurysms.
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6 months.
|
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Subgroup analysis of different gender (male vs. female), age (≤ 54 years or. >54 years), subarachnoid hemorrhage status (with vs. without SAH) of patients
Time Frame: 6 months.
|
To compare diagnostic performances for intracranial aneurysms between intervention and control arm in subgroups of different gender (male vs. female), age (≤ 54 years or.
>54 years), subarachnoid hemorrhage status (with vs. without SAH) of patients.
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6 months.
|
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Patient-wise sensitivity and specificity for patients with previous head digital subtraction angiography or surgery or not.
Time Frame: 6 months.
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To compare diagnostic performances of patient-wise sensitivity and specificity for intracranial aneurysms between intervention and control arm in subgroups of patients with previous head angiography or surgery or not.
|
6 months.
|
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Patient-wise sensitivity and specificity for patients with subsequent head digital subtraction angiography or surgery or not.
Time Frame: 6 months.
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To compare diagnostic performances of patient-wise sensitivity and specificity for intracranial aneurysms between intervention and control arm in subgroups of patients with subsequent head angiography or surgery or not.
|
6 months.
|
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Ethical safety outcomes.
Time Frame: 6 months.
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The monthly reported detection rates of intracranial aneurysms, tumors, stenosis, and occlusive are calculated and compared with the reported detection rates in the previous 3 months during the trial.
|
6 months.
|
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Learning curve of AI-augmented intracranial aneurysm diagnosis.
Time Frame: 6 months.
|
Dynamic changes in sensitivity and specificity of aneurysm diagnosis from the first 7-days through to the last 7-days of all center trials.
|
6 months.
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Trial Manager, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2022NZKY-015-05
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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