“If we use bad or limited data and human experts don’t correct the bad data or classifications, AI can produce inaccurate and wrong recommendations,” Broderick said. “My biggest concern is when AI is trained on bad data and gives answers that can harm.”  

Researchers will also need to develop strict protocols and safeguards to keep patient information used to train the models private and HIPAA compliant. This could look like independent third parties such as the American Heart Association centrally collecting anonymized patient data before it is fed to AI models, or training models with data only from each individual institution before sharing the learned parameters more broadly.

“Protection of patient privacy represents a major challenge to the use of clinical data for training AI in healthcare, and sharing of even de-identified data between countries is made more challenging by different laws regarding data sharing in various countries,” the coauthors wrote. “New methods of model development hold promise to address some of these privacy concerns.”

After robust stroke AI models are developed and validated by humans, Broderick said potential applications include better identification of potential trial participants, communicating trial designs to patients in lay language, translating trial information into different languages for non-English speaking patients and helping identify the best treatment for each individual patient.

“We have been talking about precision medicine for some time, but AI is a major step forward to accomplish this,” he said.

In addition to AI, the authors discussed new clinical trial designs, such as platform trials, which can more efficiently test several research questions at once and add new questions as older questions are answered. Another major focus going forward is pragmatic trials, which aim to assess the effectiveness of treatments when they are implemented into routine clinical care rather than under idealized conditions. 

By comparing existing treatments, embedding trial procedures into normal clinical workflows and using data from the electronic health record, researchers and organizations can lower the costs associated with these types of pragmatic trials and simplify their infrastructure. Pragmatic designs hopefully increase the chances that a trial is accomplished successfully, timely and inexpensively.

Finally, the stroke research community needs more community and patient engagement. This should include input from the boots-on-the-ground medical personnel (EMTs, physicians at transferring and receiving facilities, and study coordinators) who enroll and treat stroke patients in clinical trials.

Common goals for a trial should be established to minimize patient and investigator burden in trial participation, extend trial participation to community-based settings whenever possible, and quickly disseminate trial results to patients, clinicians and the public.

“The future is bright, and we will make great progress in research with these new tools,” Broderick said. “At the same time, the real test of our current age with the rapid expansion of AI into our daily lives is recognizing accurate data and truth amid a sea of words, images and videos that can be wrong, harmful or inaccurate.”

“Fire can burn down a house as easily as it warms the body or cooks a meal,” he continued. “AI is a fire that is rapidly spreading, but we are just beginning to learn how best to use it safely and wisely.”