Domain-Specific Large Language Model Assistance for Emergency Neurological Diagnosis and Treatment（DEMAND）

This study will evaluate whether Xuanwu-NeuroAid 2.0, a large language model for emergency neurology, can improve 30-day diagnostic quality in adults with acute neurological symptoms. Physicians will be randomly assigned to AI-assisted care or usual care. In the AI-assisted group, the model will provide diagnostic and management suggestions, while physicians will make all final clinical decisions. The usual-care group will receive standard emergency neurology care without large language model assistance.

Inclusion Criteria: * Age ≥18 years; * Presentation to the emergency neurology service with acute neurological symptoms; * Written informed consent provided by the patient or a legally authorized representative. Exclusion Criteria: * Presentation primarily for trauma; * Pregnancy; * Requiring immediate life-saving interventions; * Estimated life expectancy of less than 30 days; * Participation in another clinical trial within the previous 30 days or in a trial that could interfere with the study or outcome assessment; * Any condition that, in the opinion of the investigators, would interfere with the conduct of the trial or the interpretation of the results.