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Silent Deployment and Prospective Evaluation of Zhunxin Agent for Emergency Chest Pain Assessment

2026年9月14日更新者：Yujie Xiao、Peking University Health Science Center

A Prospective Multicenter Silent Deployment Study Evaluating the Clinical Performance of Zhunxin Agent for Emergency Chest Pain Assessment in ZERO-SL Study

The goal of this prospective, multicenter observational study is to evaluate how well Zhunxin Agent, an artificial intelligence system for chest pain assessment, performs in real-world emergency department settings. The study will include people who receive routine care for acute chest pain at participating hospitals.

The main questions this study aims to answer are:

How accurately can Zhunxin Agent identify serious causes of acute chest pain during routine emergency care?
How well can Zhunxin Agent distinguish people at different levels of clinical risk?

Zhunxin Agent will run in silent mode using clinical information collected during routine care. Its predictions will not be shown to treating clinicians and will not affect clinical decisions, diagnostic tests, or treatment.

Researchers will compare the predictions made by Zhunxin Agent with the final clinical diagnoses established through routine medical care.

Participants will:

Receive usual emergency care according to local clinical practice
Have routinely collected clinical data analyzed by Zhunxin Agent in the background
Receive no additional treatment or clinical intervention based on the Agent's predictions

研究概览

地位

尚未招聘

条件

研究类型

观察性的

注册 (估计的)

10000

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年及以上 (成人、年长者)

接受健康志愿者

不适用

有资格学习的性别

全部

取样方法

概率样本

研究人群

The study population will consist of consecutive participants presenting with acute chest pain or symptoms suggestive of an acute chest pain condition to the emergency departments of participating hospitals during the prospective silent-deployment period. Participants will receive routine clinical care, while Zhunxin Agent will operate in the background without providing its predictions to treating clinicians.

描述

Inclusion Criteria:

Participants aged 18 years or older.
Participants presenting to a participating emergency department with acute chest pain, chest discomfort, or other symptoms that prompt clinical evaluation for an acute chest pain-related condition.
Participants undergoing an electrocardiogram as part of routine clinical care during the index emergency department encounter.
Participants with at least one electrocardiogram that can be processed by Zhunxin Agent during the index emergency department encounter.
Participants with the routinely collected clinical information required for Zhunxin Agent to generate a valid prediction.
Participants presenting to a participating study site during the prospective study period.

Exclusion Criteria:

Participants whose emergency department presentation does not involve evaluation for acute chest pain.
Participants without an electrocardiogram obtained during the index emergency department encounter.
Participants for whom the electrocardiogram or other required input data are missing, corrupted, technically inaccessible, or otherwise unusable such that Zhunxin Agent cannot generate a valid prediction.
Duplicate records corresponding to the same emergency department encounter.
Participants whose clinical data cannot be used for research because of withdrawal of consent, refusal of data use where applicable, or other ethical, institutional, or regulatory restrictions.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

观测模型：COHORT
时间观点：PROSPECTIVE

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
Percentage of Participants Correctly Classified by Zhunxin Agent Across the Prespecified Acute Chest Pain Diagnostic Categories 大体时间：Up to 30 days after emergency department presentation	Diagnostic accuracy will be reported as the percentage of evaluable participants for whom the final diagnostic classification generated by Zhunxin Agent matches the final reference diagnosis. The prespecified diagnostic categories are unstable angina, non-ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction, aortic dissection, pulmonary embolism, and other causes of chest pain. The numerator will be the number of participants with a concordant Zhunxin Agent classification and reference diagnosis, and the denominator will be the total number of evaluable participants with both a valid Zhunxin Agent prediction and an available final reference diagnosis.	Up to 30 days after emergency department presentation

次要结果测量

结果测量	措施说明	大体时间
Diagnostic Performance of Zhunxin Agent for High-Risk Acute Chest Pain Conditions Assessed by Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and AUROC 大体时间：Up to 30 days after emergency department presentation	Diagnostic performance of Zhunxin Agent will be evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic curve (AUROC), using the final reference diagnosis as the reference standard. Prespecified high-risk acute chest pain conditions include ST-segment elevation myocardial infarction, aortic dissection, and pulmonary embolism. Sensitivity will be calculated as the proportion of participants with a target condition who are correctly identified by Zhunxin Agent. Specificity will be calculated as the proportion of participants without the target condition who are correctly identified as negative. PPV will be calculated as the proportion of participants with a positive Zhunxin Agent prediction who have the target condition, and NPV as the proportion of participants with a negative prediction who do not have the target condition. AUROC will be calculated using the predicted probabili	Up to 30 days after emergency department presentation
Percentage of Participants With a Confirmed High-Risk Acute Chest Pain Condition Within Each Zhunxin Agent Risk Category 大体时间：Up to 30 days after emergency department presentation	The clinical risk stratification performance of Zhunxin Agent will be evaluated by calculating the percentage of participants with a confirmed high-risk acute chest pain condition within each prespecified risk category. Zhunxin Agent classifies participants into low-, intermediate-, and high-risk categories for ST-segment elevation myocardial infarction, aortic dissection, and pulmonary embolism using prespecified thresholds. For each target condition and risk category, the numerator will be the number of participants with the corresponding final reference diagnosis, and the denominator will be the total number of participants assigned to that risk category. The proportions will be reported separately for the low-, intermediate-, and high-risk categories.	Up to 30 days after emergency department presentation

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Peking University Health Science Center

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年9月9日

初级完成 (估计的)

2030年9月9日

研究完成 (估计的)

2030年10月9日

研究注册日期

首次提交

2026年9月9日

首先提交符合 QC 标准的

2026年9月14日

首次发布 (实际的)

2026年9月21日

研究记录更新

最后更新发布 (实际的)