ABSTRACT NUMBER: ESOC2026A2262 STROKE-AR: ASSISTED REALITY-BASED REMOTE SUPERVISION OF STROKE UNIT WARD ROUNDS - A PROSPECTIVE FEASIBILITY PILOT STUDY

Abstract Background and aims Most telestroke models focus on the hyperacute phase and acute stroke therapies, while post-acute management is less frequently covered. Assisted reality (AR) technologies enable real-time audiovisual transmission from the examiner’s perspective, making them suitable for routine ward rounds. The aim of this study is to explore the feasibility of AR-based remote supervision of stroke unit ward rounds. Methods This is a prospective, controlled pilot study conducted at a tertiary stroke unit, designed to simulate a peripheral hospital setting without continuous on-site stroke expertise. Acute stroke patients admitted within 24 hours of symptom onset are included. Over a 12-week study period, two ward rounds per week are randomized 1:1 to AR-supported remote supervision or standard on-site senior supervision. On intervention days, residents conduct ward rounds wearing an AR headset and are connected to a senior stroke neurologist, who can guide examination steps and participate in clinical decision-making, including NIHSS assessment. On control days, ward rounds are conducted by an on-site senior stroke neurologist. The primary endpoint is feasibility, defined as successful AR-supported supervision without major technical failure. Secondary endpoints include system usability, perceived decision support, educational value, time metrics and interrater reliability of NIHSS assessments. NIHSS is additionally assessed by an independent rater blinded to study allocation. Results Study completion is expected in April 2026. Conclusions STROKE-AR will provide prospective data on the feasibility and reliability of AR-supported telemedical stroke unit ward rounds and may help to define the role of AR technologies in routine stroke care. Conflict of interest Daniela Schöne: nothing to disclose, Annahita Sedghi: nothing to disclose, Martin Arndt: nothing to disclose, Marie Nicklas: nothing to disclose, Norma J. Diel: nothing to disclose, Hagen B. Huttner: nothing to disclose, Timo Siepmann: nothing to disclose, Kristian Barlinn: nothing to disclose Figure 1 - belongs to Conclusions