For one subject-specific DTH, its value in clinical practice will be evaluated. For this evaluation, we selected the Ischemic Stroke Treatment Selection DTH (ISTS-DTH), which estimates the chance of first pass success and clot fragmentation given a treatment and patient-specific characteristics. We will evaluate the value of this DTH as a treatment selection support tool. The trial will run in the AMC and EMC, will run for 12 months and will include 300 patients. Proof of utility added value for clinical and patient outcomes will be addressed for multiple stakeholders (e.g., patients, clinicians), on a wide range of timescales (direct technical treatment success, and long-term functional outcome), and with multiple outcome measures across the continuum of stroke disease evolution. The trial will also be utilised to address the ethical and societal challenges concerning the use of DTHs in emergency situations by analysing normative concepts (agency representation and embodiment) and addressing procedural conditions of consent, controllability and trust, which are focal to GEMINI. Budgetary, timing and ethical constraints limit the number of DTHs that can be evaluated in clinical trials to one.
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