Clinical Validation of an Artificial Intelligence-Based Scoring System for the Modified Rankin Scale (mRS) in Patients With Stroke

April 15, 2026 updated by: qingfeng ma, Xuanwu Hospital, Beijing
This study aims to validate the clinical performance of an artificial intelligence (AI)-based automatic scoring system for the Modified Rankin Scale (mRS). The core comparison is the consistency and accuracy between the AI-generated scores and standardized manual mRS follow-up assessments performed by trained professionals. The goal is to provide a convenient, efficient, and objective tool for stroke prognosis assessment, reduce the subjective variability of manual scoring, and optimize the stroke follow-up workflow.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

This is a prospective, multicenter, observational study designed to validate the diagnostic performance of an AI-based automated scoring system for the Modified Rankin Scale (mRS) in patients with stroke. The primary objective is to evaluate the agreement between AI-generated mRS scores and standardized manual assessments conducted by trained clinicians. Secondary endpoints include the system's sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) in classifying functional outcomes.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
490

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Consecutive stroke patients from multiple centers who are ≥18 years old, with confirmed stroke, and able to complete the 1-week follow-up will be enrolled. Patients with severe non-stroke neurological diseases, inability to communicate, or loss to follow-up will be excluded.

Description

Inclusion Criteria:

  1. Age ≥ 18 years, male or female.
  2. Clinically diagnosed with stroke, and confirmed by cranial CT/MRI to have stroke.
  3. Clinically stable, with basic communication ability at discharge or outpatient visit. The patient or a fixed family caregiver is able to cooperate with telephone follow-up at 1 week after discharge or outpatient visit.
  4. Signed informed consent by the patient or their legally authorized representative.

Exclusion Criteria:

  1. Neurological deficits caused by non-stroke etiologies (e.g., brain tumor, traumatic brain injury, encephalitis).
  2. Presence of severe disturbance of consciousness, severe cognitive impairment, psychiatric disorders, or global aphasia at discharge/outpatient visit, preventing effective communication; neither the patient nor family can cooperate with follow-up or assessment.
  3. Combined with severe multi-organ failure (e.g., cardiac, hepatic, renal, respiratory), with an expected survival of less than 1 month, making completion of the 1-week follow-up impossible.
  4. Long-term bedridden without a fixed caregiver, with no confirmed contact for follow-up, or refusal to participate in telephone follow-up and mRS assessment.
  5. Incomplete clinical data, preventing baseline data collection.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
AI-first interview group
Participants first receive telephone assessment by AI, followed by telephone assessment by human assessors.
Human-first group
Participants first receive telephone assessment by human assessors, followed by telephone assessment by AI.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Agreement Between Artificial Intelligence (AI)-Based and Manual Modified Rankin Scale (mRS) Assessments
Time Frame: 7 days post-discharge or post-outpatient visit, ± 2 days
The weighted kappa coefficient quantifies the level of agreement between the Artificial Intelligence (AI)-generated Modified Rankin Scale (mRS) scores and the standardized manual mRS assessments performed by trained clinicians
7 days post-discharge or post-outpatient visit, ± 2 days

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Agreement Between AI-based and Manual Assessments of Dichotomized Modified Rankin Scale (mRS)
Time Frame: 7 days post-discharge or post-outpatient visit, ± 2 days
The simple kappa coefficient quantifies the level of agreement between the Artificial Intelligence (AI)-generated dichotomized Modified Rankin Scale (mRS) scores (0-2 vs. 3-6) and the standardized manual mRS assessments performed by trained clinicians
7 days post-discharge or post-outpatient visit, ± 2 days
Bland-Altman Limits of Agreement Between AI and Manual Modified Rankin Scale (mRS) Scores
Time Frame: 7 days post-discharge or post-outpatient visit, ± 2 days
The Bland-Altman limits of agreement analysis evaluates the consistency between the Artificial Intelligence (AI)-generated and manually assessed Modified Rankin Scale (mRS) scores. The difference between manual and AI scores will be plotted on the y-axis against their mean on the x-axis, with limits of agreement (mean difference ± 1.96 × standard deviation) calculated. The analysis aims to visually assess how agreement varies across the range of mRS scores and identify any proportional bias, such as greater disagreement in patients with severe disability.
7 days post-discharge or post-outpatient visit, ± 2 days
Diagnostic Performance of AI-Based vs. Manual Modified Rankin Scale (mRS) Dichotomization
Time Frame: 7 days post-discharge or post-outpatient visit, ± 2 days
The diagnostic performance analysis evaluates the ability of the Artificial Intelligence (AI)-based Modified Rankin Scale (mRS) scoring system to classify functional outcomes, using manual assessment as the reference standard. A 2×2 contingency table will be constructed for the dichotomized mRS categories (good outcome: 0-2 vs. poor outcome: 3-6). The analysis will calculate sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and Youden's index. A receiver operating characteristic (ROC) curve will be plotted, and the area under the curve (AUC) will be computed.
7 days post-discharge or post-outpatient visit, ± 2 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Xuanwu Hospital, Beijing

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Beijing Tiantan Hospital
Capital Medical University
The First Hospital of Fangshan District,Beijing
People's Hospital of Beijing Daxing District

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Qingfeng Ma, MD, Xuanwu Hospital, Beijing

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 10, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 31, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 15, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 22, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 22, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 15, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • qingfeng ma AI mRS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Due to the protection of participant privacy and institutional review board requirements, individual participant data (IPD) will not be shared publicly.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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