ABSTRACT NUMBER: ESOC2026YS166 SAFE-AR: ASSISTED REALITY-BASED REMOTE SUPERVISION IN ACUTE STROKE CARE - A PROSPECTIVE PILOT STUDY

Abstract Background and aims Acute stroke care requires rapid decision-making under significant time pressure. In many emergency departments, initial assessment is performed by residents, particularly during off-hours, with senior neurologists providing supervision by telephone. This setting may increase uncertainty and workload for residents and affect decision-making quality. Assisted reality (AR) technologies allow real-time audiovisual transmission from examiner’s perspective and enable visual remote supervision. The aim of SAFE-AR is to provide prospective data on the feasibility and potential clinical value of AR-based remote supervision in acute stroke care. Findings may help to define the role of AR technologies in supporting clinical decision-making and resident training in time-critical stroke care and inform the design of larger outcome-focused studies. Methods This is a prospective single-center controlled pilot study with day-wise randomization to AR-supported supervision or standard care. Patients with suspected acute stroke and symptom onset <24 hours are included. On intervention days, residents wear an AR headset during initial assessment when deemed necessary by resident, supervising senior neurologist, or both. On control days, supervision is provided by telephone only. Clinical decision-making follows routine standard-of-care algorithms in both study arms. Primary endpoint is feasibility, defined as successful AR-supported supervision without major technical failure. Secondary endpoints include system usability (system usability scale), perceived safety and decision support, educational value and stroke process metrics. Results Recruitment is ongoing. Study completion is expected in May 2026. Conflict of interest "Norma J. Diel: nothing to disclose", "Eyad Altarsha: nothing to disclose", "Simon Winzer: nothing to disclose", "Patrick Schramm: nothing to disclose", "Daniela Schoene: nothing to disclose", "Timo Siepmann: nothing to disclose", " Hagen B. Huttner: nothing to disclose", "Kristian Barlinn: nothing to disclose"