{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:04:52Z","timestamp":1790262292204,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Large language models (LLMs) may support patient education, but their clinical use remains challenging. We aimed to evaluate the preliminary feasibility of a structured clinical input\u2013guided LLM workflow for generating discharge education drafts for patients with acute ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients with acute ischemic stroke discharged from 6 tertiary stroke centers in China between September 1, 2024, and March 31, 2025, were included. The workflow comprised electronic medical record\u2013based data extraction, mapping to a predefined deidentified case report form, manual verification, standardized prompt-based LLM draft generation, and clinician-facing draft output. For each patient, Chinese-language discharge education drafts were generated using GPT-4o, Grok-3, and DeepSeek-R1. Physician-written discharge instructions prepared during routine clinical practice served as reference materials. Two blinded senior neurologists evaluated the materials across 5 predefined domains. Patient-centered evaluation was conducted in 50 patients. Interrater agreement between the 2 neurologists was assessed using intraclass correlation coefficients. Group comparisons were performed using Friedman tests followed by Bonferroni-corrected Wilcoxon signed-rank tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 67 patients with acute ischemic stroke were included. The mean age was 63.6\u00b111.0 years, and 45 patients were men (67.2%). Interrater agreement was good to excellent, with intraclass correlation coefficients ranging from 0.862 to 0.943. Post hoc analyses showed that each LLM-generated draft group received higher expert ratings than physician-written discharge instructions in risk factor control, rehabilitation guidance, follow-up planning, and health education (all Bonferroni-adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), whereas no pairwise difference in medication management remained significant after correction. Patient-centered ratings were generally favorable, and GPT-4o and Grok-3 received higher empathy ratings than physician-written discharge instructions (both Bonferroni-adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). No clear hallucinations were identified during expert review, and LLM drafts had fewer unacceptable ratings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>A structured clinical input\u2013guided LLM workflow showed preliminary feasibility for generating clinician-supervised acute ischemic stroke discharge education drafts. Prospective implementation studies are warranted to evaluate workflow integration, usability, and effects on patient-reported and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.126.055189","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:15:59Z","timestamp":1784636159000},"page":"2709-2718","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Structured Clinical Input\u2013Guided Large Language Model Workflow for Acute Ischemic Stroke Discharge Education: A Multicenter Feasibility Study"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4001-877X","authenticated-orcid":true,"given":"Juntao","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8262-1449","authenticated-orcid":true,"given":"Wan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China (Wan Wang)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurology, Langfang People\u2019s Hospital, China (T.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guofeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingtao","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.Y., L.W., Z.L., Weiwei Wang, G.L., L.T., X.Z.), Xingtai Central Hospital, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haolong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shijiazhuang People\u2019s Hospital, China (H.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7107-1888","authenticated-orcid":true,"given":"Li","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Science and Education (L.F.), Xingtai Central Hospital, 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