Evidence mapPaperPMID 42455845Full record

ArticlePloS one2026

An explainable artificial intelligence framework for clinical decision support in stroke discharge planning.

Seifollah Gholampour, Arshia Dehghan, Evelyn B Voura, Jesse Huang, Mohammad Jamshidi, George W Koutsouras

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Seifollah GholampourDepartment of Neurological Surgery, University of Chicago Medicine, Chicago, Illinois, United States of America.ORCID https://orcid.org/0000-0002-4924-4239
Arshia DehghanDepartment of Neurological Surgery, University of Chicago Medicine, Chicago, Illinois, United States of America.
Evelyn B VouraCrouse Neuroscience Institute, Crouse Health at Crouse Hospital, Crouse Medical Practice, Syracuse, New York, United States of America.
Jesse HuangDepartment of Neurological Surgery, University of Chicago Medicine, Chicago, Illinois, United States of America.
Mohammad JamshidiDepartment of Neurology, Northwestern University, Chicago, Illinois, United States of America.
George W KoutsourasDepartment of Neurosurgery, Upstate University Hospital, Syracuse, New York, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke, a leading cause of global mortality and disability, requires accurate prediction of discharge outcomes to support early care planning. We developed an explainable artificial intelligence (AI) framework to predict four discharge categories (home, specialized care, home with help, expired) and identify key predictors.

methodsThis single-center retrospective study included 1,731 patients with ischemic stroke, hemorrhagic stroke, or transient ischemic attack (TIA). Twenty routinely available electronic health record variables were used. Ten classifiers were compared using stratified 5-fold cross-validation, and the final model was calibrated with training-set out-of-fold predictions and interpreted using SHapley Additive exPlanations (SHAP).

resultsThe multilayer perceptron (MLP) achieved the highest mean cross-validated macro-F1 score and was selected as the best-performing model. On the independent hold-out test set, the MLP achieved an accuracy of 0.646, macro-specificity of 0.873, macro-precision of 0.559, macro-sensitivity of 0.557, and macro-F1 of 0.548. Class-wise area under the receiver operating characteristic curve (AUC) values were 0.901 for home, 0.874 for specialized care, 0.674 for home with help, and 0.889 for expired. SHAP analysis identified admission National Institutes of Health Stroke Scale (NIHSS), length of stay, age, and primary diagnosis as shared predictors across all discharge categories. The SHAP age-threshold analysis identified 72.0 years as a clinically relevant threshold associated with a lower likelihood of home discharge and higher likelihoods of specialized care, home with help, and expired discharge status. The model also highlighted clinically actionable or addressable domains, including blood glucose, depression, insurance type, last known well time, anticoagulant use, and treatment-related variables.

conclusionThis interpretable AI-based framework identified clinically relevant predictors of stroke discharge disposition within this single-center retrospective dataset. These findings may inform future decision-support development; however, clinical implementation, resource optimization, and health-system impact require prospective multicenter validation.

Indexed as

Artificial IntelligenceDecision Support Systems, ClinicalPatient DischargeStrokeAgedAged, 80 and overElectronic Health RecordsFemaleHumansMaleMiddle AgedPredictive Learning ModelsRetrospective Studies

Identifiers

PMID42455845
PMCPMC13372143

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.