{"id":"AIBD-0637","title":"Stepped-wedge cluster-randomized trial at four Houston stroke centers: Viz.ai automated LVO detection cuts door-to-groin time by 11 minutes","summary":"At four Houston comprehensive stroke centers, Viz.ai LVO detection with mobile alerts cut door-to-groin time for thrombectomy by 11.2 minutes.","date_observed":"2022-02-27","date_basis":"event","date_precision":"day","benefit_status":"reported","source_collection":null,"source_entry":null,"account":"Researchers at UTHealth Houston ran a cluster-randomized stepped-wedge trial from 1 January 2021 to 27 February 2022 at four comprehensive stroke centers in the Houston area. The centers switched on, in random order, cloud-based Viz.ai software that reads CT angiograms for large vessel occlusion and sends alerts to clinicians' phones within minutes of the scan. Among 243 patients with large vessel occlusion stroke who arrived through the emergency department and had thrombectomy, the time from hospital arrival to groin puncture fell by 11.2 minutes (95% CI 4.2 to 18.2) after activation, from a pre-activation median of 100 minutes. Time from CT to thrombectomy start fell by 9.8 minutes, while tPA treatment times and length of stay did not change. The senior author reported grants from Viz.AI during the study. In 2025, a meta-analysis of 12 studies with 15,595 patients, by authors who declare no competing interests, reported that Viz.ai use was associated with shorter door-to-groin times, with no significant difference in clinical outcomes.","category":"general benefit","unexpected":false,"purpose":"The software was built to detect large vessel occlusion on CT angiograms and alert stroke teams. Faster thrombectomy was that purpose.","system":"Viz.ai automated large vessel occlusion detection with secure group messaging","model_version":null,"developer":"Viz.ai","deployer":"Four comprehensive stroke centers in the greater Houston area (UTHealth Houston trial)","location":"Four comprehensive stroke centers, greater Houston, Texas, United States","domain":"Healthcare","segment":null,"benefit_type":"Reduced Task Time","taxonomy_note":null,"registry_ids":{},"ratings":[{"group":"personal","depth":2,"reason":"Patients reached thrombectomy 11.2 minutes sooner after hospital arrival, in a treatment whose benefit depends on time."},{"group":"organizational","depth":1,"reason":"Time from CT to thrombectomy start fell by 9.8 minutes."}],"ai_role":{"status":"assessed","statement":"Centers switched the software on in random order, so the trial compares treatment times with and without the AI alerts; the alerts came bundled with secure group messaging, which the trial does not separate from the detection."},"evidence":[{"kind":"peer-reviewed study","citation":"Martinez-Gutierrez JC, Kim Y, Salazar-Marioni S, et al. Automated Large Vessel Occlusion Detection Software and Thrombectomy Treatment Times: A Cluster Randomized Clinical Trial. JAMA Neurol. 2023;80(11):1182-1190.","title":"Automated Large Vessel Occlusion Detection Software and Thrombectomy Treatment Times: A Cluster Randomized Clinical Trial","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10507590/","date":"2023-09-18","written_by":"makers","quote":"In mixed-effects linear regression, implementation of the AI algorithm was associated with a reduction in DTG time by 11.2 minutes (95% CI, -18.22 to -4.2)."},{"kind":"peer-reviewed study","citation":"Sarhan K, Azzam AY, Moawad MHED, et al. Automated Emergent Large Vessel Occlusion Detection Using Viz.ai Software and Its Impact on Stroke Workflow Metrics and Patient Outcomes in Stroke Centers: A Systematic Review and Meta-analysis. Transl Stroke Res. 2025;16(6):2258-2271.","title":"Automated Emergent Large Vessel Occlusion Detection Using Viz.ai Software and Its Impact on Stroke Workflow Metrics and Patient Outcomes in Stroke Centers: A Systematic Review and Meta-analysis","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12596299/","date":"2025-05-08","written_by":"independent","quote":"The pooled analysis demonstrated that the implementation of the Viz.ai algorithm was associated with lesser CT scan to EVT time (SMD -0.71, 95% CI [-0.98, -0.44], p < 0.001) and DTG time (SMD -0.50, 95% CI [-0.66, -0.35], p < 0.001)"}],"replication":{"produced_by":["Every CT angiogram for suspected stroke went to the cloud algorithm automatically.","Alerts reached clinicians and radiologists by phone with secure group messaging."],"must_hold":["Stroke teams must act on phone alerts before the formal report.","The centers must have thrombectomy capacity on site."],"echoes":[{"date":"2020-07-01","setting":"A comprehensive stroke center serving a mostly Hispanic urban population, before and after Viz LVO (authors at HCA Healthcare, Miami, Florida, and one author at Viz.ai)","model_version":null,"outcome":"recurred","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13694361/"},{"date":"2025-05-08","setting":"Meta-analysis of 12 studies of Viz.ai at stroke centers, 15,595 patients","model_version":null,"outcome":"recurred","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12596299/"}]},"paired_incident":null,"headline":"Automated scan alerts help Houston stroke teams start treatment sooner","metric":"fell by 11.2 minutes (95% CI 4.2 to 18.2) after activation","comparator":{"against":"The same centers before activation","before":"Median door-to-groin time of 100 minutes before activation","after":"Door-to-groin time 11.2 minutes shorter after activation (adjusted)","basis":"measured","quote":"implementation of automated large vessel occlusion detection software led to a statistically significant reduction of 11 minutes in time to thrombectomy initiation","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10507590/"},"later":null,"value":null,"developer_country":"United States","deployer_country":"United States","unrated_because":null,"brief_notes":null,"brief":null,"revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10507590/","editor":"AIBD"}],"confidence":"studied","shade":"high","claim_status":"Independently studied","claim_basis":"Sources: one independent peer-reviewed study and the makers' peer-reviewed study. 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