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Construction and Validation of a Coronary Artery Disease-Specific Large Language Model and Its Evaluation Framework (CorAI) (CorAI)

11. august 2026 opdateret af: China National Center for Cardiovascular Diseases

A Prospective, Multicenter, Observational Cohort Study for the Construction of a Multimodal Coronary Artery Disease Dataset and the Development, Evaluation, and External Validation of a Disease-Specific Large Language Model (CorAI)

Coronary artery disease (CAD) affects an estimated 11.39 million people in China, and mortality has continued to rise since 2012. Quality-of-care data indicate persistent gaps in diagnostic and therapeutic guideline adherence, incomplete implementation of secondary prevention, and suboptimal risk-factor control. Large language models (LLMs) can rapidly retrieve and integrate literature, medical records, and multimodal clinical data, and may support clinical decision-making. However, most existing medical LLMs are general-purpose, are trained predominantly on published literature and web text rather than authentic clinical records, and have not been validated with real patient data. No disease-specific LLM for CAD currently exists, and no evaluation framework tailored to CAD has been established; existing benchmarks are general-purpose, lack specialty-specific risk grading, are not rigorously anchored to current guidelines, and emphasize literal accuracy over clinically critical reasoning steps and prescription concordance.

This prospective, multicenter, observational study will enroll approximately 640 patients with confirmed or suspected CAD at Fuwai Hospital and collaborating centers. No study-specific intervention, examination, biospecimen collection, or additional follow-up visit is performed; all clinical decisions are made independently by the treating physician according to routine standards of care. For consenting participants, routinely generated clinical documentation from the index outpatient visit or hospitalization - including medical history, laboratory results, imaging and coronary angiography/coronary CT angiography reports, physician notes, online consultation records, and follow-up records - will be de-identified and used to construct a high-quality multimodal CAD dataset. This dataset will support the development of a CAD-specific large language model (CorAI), the construction of an evaluation framework spanning eight predefined clinical scenarios and multiple assessment dimensions, and external validation of the model at participating centers.

The primary objectives are to characterize the completeness and quality of the constructed prospective cohort dataset, and to quantify the guideline concordance of CorAI-generated clinical recommendations as adjudicated by a blinded panel of cardiologists.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Anslået)

640

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Kina
    • Anhui
      • Hefei, Anhui, Kina, 230001
        • The First Affiliated Hospital of USTC
        • Kontakt:
    • Beijing Municipality
      • Beijing, Beijing Municipality, Kina, 100037
        • Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases
        • Kontakt:
        • Kontakt:
    • Guangdong
      • Shenzhen, Guangdong, Kina, 518057
        • Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients with confirmed or suspected coronary heart disease.

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years;
  • Patients with confirmed or suspected coronary heart disease;
  • Complete case information (including medical history, test results, imaging, follow-up records, etc.);
  • Consent for the use of case data for model evaluation and research analysis.

Exclusion Criteria:

  • Cases with severe data gaps that prevent the formation of a complete clinical scenario;
  • Cases where the primary diagnosis is not coronary heart disease;
  • Cases with serious data errors or where data cannot be anonymized.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
CorAI development and evaluation cohort
Adults aged 18 years or older with confirmed or suspected coronary artery disease presenting for routine outpatient or inpatient care at a participating center. Routinely generated clinical documentation is de-identified and used for construction of a multimodal CAD dataset and for development and evaluation of a disease-specific large language model. No study-specific intervention, testing, or follow-up is performed.
Andet: Ingen intervention: Observationskohorte
Ingen intervention: Observationskohorte

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Completeness of the constructed multimodal CAD dataset
Tidsramme: From enrollment of the first participant through completion of dataset construction, up to 12 months
Proportion of enrolled participants whose de-identified record satisfies all pre-specified data-completeness criteria, defined as the presence of medical history, comorbidity and medication documentation, laboratory results, electrocardiography, coronary CT angiography and/or invasive coronary angiography findings, and at least one structured follow-up or discharge record sufficient to reconstruct a complete clinical scenario. Reported as a percentage with 95% confidence interval.
From enrollment of the first participant through completion of dataset construction, up to 12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Guideline concordance of CorAI-generated clinical recommendations across eight predefined coronary artery disease scenarios
Tidsramme: At completion of model development and evaluation, up to 18 months
Proportion of CorAI responses judged fully concordant with the coronary artery disease clinical practice guidelines in force at the time of adjudication, assessed on the held-out evaluation set across eight predefined clinical scenarios: (1) initial evaluation of chest pain; (2) coronary artery assessment; (3) antithrombotic therapy; (4) revascularization decision-making; (5) lipid-lowering therapy; (6) post-procedural management; (7) post-procedural complications; and (8) patient education and physician-patient communication. Each item is scored as concordant, partially concordant, or discordant by cardiologists blinded to response source using a pre-specified rubric, with disagreements resolved by an independent third adjudicator. The primary metric is the pooled percentage of items scored fully concordant across all eight scenarios, reported with a 95% confidence interval.
At completion of model development and evaluation, up to 18 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

China National Center for Cardiovascular Diseases

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

17. august 2026

Primær færdiggørelse (Anslået)

1. januar 2027

Studieafslutning (Anslået)

31. august 2027

Datoer for studieregistrering

Først indsendt

11. august 2026

Først indsendt, der opfyldte QC-kriterier

11. august 2026

Først opslået (Faktiske)

14. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

14. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2025-GSP-GG-18-3
  • 2025-GSP-GG-18 (Andet bevillings-/finansieringsnummer: the National High Level Hospital Clinical Research Funding (China))

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

IPD-planbeskrivelse

De-identified individual participant data underlying reported results may be made available on reasonable request to the corresponding author, subject to approval by the Ethics Committee of Fuwai Hospital and to compliance with applicable Chinese regulations governing the cross-border transfer of human genetic resources and health data. The study protocol and the pre-specified evaluation rubric will be made available alongside publication.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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