Deans' stroke musings: Dual-knowledge-driven interpretable decision support system for stroke critical-care rehabilitation: design and multi-center study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, February 9, 2025

Dual-knowledge-driven interpretable decision support system for stroke critical-care rehabilitation: design and multi-center study

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation!

RECOVERY IS THE ONLY GOAL IN STROKE! GET THERE!

Dual-knowledge-driven interpretable decision support system for stroke critical-care rehabilitation: design and multi-center study

Ziming Yin1,4, Yanhao Gong1, Jing He2,5, Ling Ren2,5, Xin Li3, Xianrui Hu2,5, Yu Pan3 and

Hongliu Yu1,4, Senior Member, IEEE

1School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China

2Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, China

3Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China

4Shanghai Engineering Research Center of Assistive Devices, University of Shanghai for Science and Technology, Shanghai 200093, China

5Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China

Corresponding author: Hongliu Yu (yhl98@hotmail.com).

This work was supported by the National Key R&D Program of China, grant number 2022YFC3601101.

ABSTRACT

The study aimed to develop a clinical decision support system for stroke critical-care

rehabilitation in medical intensive care units (ICUs) to address the challenges of complex patient conditions, diverse rehabilitation needs, and subjectivity in physician prescriptions. This study proposed a dual-knowledge-driven intelligent rehabilitation decision support system (RDSS) for personalized intensive-care(NOT RECOVERY!) rehabilitation of severe-stroke patients. The system uses proposed collaborative reasoning that integrates semantic reasoning and knowledge graph-based reasoning to recommend rehabilitation plan, other relevant treatment options, potential complications and comorbidities, and risk factors to consider based on the patient's clinical context information. A comparative evaluation study and a retrospective study were conducted respectively. The results of the comparative study showed that the overlap rate (73.3%) between the RDSS and the gold standard was higher than the average overlap rate (59.4%) between most (96.6%) rehabilitation professionals and the gold standard. In the retrospective study, 92 patients from two hospitals were enrolled, the overlap rate between the rehabilitation plans provided by the RDSS and those provided by the gold standard was over 50% for all cases, with nearly one-fifth achieving a 100% match. Moreover, 46.7% of rehabilitation plans had an overlap rate of 80% or higher, and the overall average overlap rate reached 78.10%. These findings suggest that the proposed RDSS demonstrated strong performance in recommending rehabilitation plans and providing risk reminders, indicating its potential feasibility for use in clinical practice