Effectiveness of an Artificial Intelligence Clinical Assistant Decision Support System to Improve the Incidence of Hospital-Associated Venous Thromboembolism: A Prospective, Randomised Controlled Study

Abstract

Abstract Background Thromboprophylaxis has been determined to be safe, effective, and cost-effective for hospitalised patients at venous thromboembolism (VTE) risk. However, Chinese medical institutions have not yet fully utilised or improperly used thromboprophylaxis given the lack of prospective studies; thus, more trials are needed. Methods All hospitalised patients aged >18 years not discharged within 24 h from 1 September 2021 to 31 May 2021 were prospectively enrolled. Patients were randomly assigned to the control (9,890 patients) or intervention group (9,895 patients). The control group implemented conventional VTE prevention programmes; the intervention group implemented an Artificial Intelligence Clinical Assistant Decision Support System (AI-CDSS) on the basis of conventional prevention. Intergroup demographics, disease status, hospital length of stay (LOS), VTE risk assessment, and VTE prophylaxis were compared using the chi-square test, Fisher’s exact test, t-test, or Wilcoxon rank-sum test. Results The control and intervention groups had similar baseline characteristics. The mean age was 58.32±15.41 years, and mean LOS was 7.82±7.07 days. In total, 5027 (25.40%) and 2707 (13.67%) patients were assessed as having intermediate-to-high VTE risk and high bleeding risk, respectively The incidence of hospital-associated VTE (HA-VTE) was 0.38%, of which 86.84% had DVT. Compared to the control group, the incidence of HA-VTE decreased by 46.00%, mechanical prophylaxis rate increased by 24.00%, and intensity of drug use increased by 9.72% in the intervention group. However, AI-CDSS use did not increase the number of clinical diagnostic tests, prophylaxis rate, or appropriate prophylaxis rate. Conclusions AI-CDSS showed a positive role in VTE risk management. Thus, it is necessary to implement evidence-based education programmes to increase physicians’ awareness of thromboprophylaxis and appropriate thromboprophylaxis rates. Trial registration This was a randomised controlled single-centre prospective study , which has been reviewed by the World Health Organization International Clinical Trial Registration Platform (11/8/2020, ChiCTR2000035452).