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AIRCHILL US Clinical & Public Data Intelligence

Public-data intelligence · CMS + ClinicalTrials.gov · v1.0 · 4 September 2026

US clinical-development intelligence built from observed public data.

This page separates observed US public-healthcare data from AIRCHILL assumptions. It uses CMS Medicare aggregate hospital records to identify burden, payment and hospital-volume signals; ClinicalTrials.gov to identify current research-network activity; and protocol-specific feasibility data before any site, market-size or recruitment conclusion is made.

Decision architecture

One source is never enough for site selection or market sizing.

Observed layer 1

CMS hospital data

Hospital × MS-DRG discharges, submitted covered charges, total payments and Medicare payments. Use: burden signal, payer context and first-pass hospital screening.

Observed layer 2

Research-network activity

ClinicalTrials.gov investigator and site activity. Use: evidence that a centre or EMS network is currently participating in relevant research; not proof that it is suitable for AIRCHILL.

Qualification layer

Protocol feasibility

EVT volume, general-anaesthesia fraction, OHCA ROSC flow, airway timing, consent pathway, device workflow, competing trials and randomisations per centre-month must be measured prospectively before pivotal site lock.

Economic layer

Observed vs modelled

CMS observed payments remain separate from AIRCHILL outcome scenarios, QALY/DALY modelling, ICU/rehabilitation assumptions and projected savings.

Governance rule: an MS-DRG is an administrative payment classification, not a disease registry. No single DRG is treated as incidence, total addressable market or expected AIRCHILL enrolment.

Stroke · first-pass US site intelligence

Use DRGs 061–066 as broad cerebrovascular burden signals — not as LVO/EVT counts.

For the 2024 CMS Medicare inpatient dataset, DRGs 064–066 cover intracranial haemorrhage or cerebral infarction by complication level; DRGs 061–063 cover ischemic stroke/precerebral occlusion/transient ischemia with thrombolytic agent. The AIRCHILL-STROKE target is narrower: anterior-circulation LVO selected for EVT with clinically indicated general anaesthesia and invasive ventilation. Therefore CMS volume is only Stage 1 of screening.

DRG 064
1,480

Published hospital-DRG rows in the 2024 dataset for intracranial haemorrhage or cerebral infarction with MCC. CMS suppresses rows with ≤10 discharges.

DRG 065
1,727

Published hospital-DRG rows for intracranial haemorrhage or cerebral infarction with CC or tPA in 24 hours.

DRG 066
558

Published hospital-DRG rows for intracranial haemorrhage or cerebral infarction without CC/MCC.

DRG 061
32

Published hospital-DRG rows for the MCC stratum of ischemic stroke/precerebral occlusion/transient ischemia with thrombolytic agent.

Example centre from CMS returned ranked pages2024 signalObserved average Medicare paymentWhy it matters
AdventHealth OrlandoDRG 064: 320 discharges; DRG 065: 238; DRG 061: 20DRG 064: $12,451; DRG 065: $6,390; DRG 061: $21,289Consistent high cerebrovascular signal across multiple CMS strata; requires EVT/GA and competing-trial qualification before use as a recruitment estimate.
NewYork-Presbyterian HospitalDRG 064: 226; DRG 065: 174; DRG 061: 19DRG 064: $25,079; DRG 065: $10,724; DRG 061: $32,406Large CMS signal plus current acute-stroke research activity in the NewYork-Presbyterian/Weill Cornell ecosystem on ClinicalTrials.gov.
ChristianaCareDRG 064: 195; DRG 065: 222; DRG 066: 63; DRG 061: 18DRG 064: $15,465; DRG 065: $7,170; DRG 066: $4,454; DRG 061: $21,232Broad observed stroke burden across complication strata; candidate for deeper EVT-capability and study-workflow screening.
Inova Fairfax HospitalDRG 064: 187; DRG 061: 15DRG 064: $16,243; DRG 061: $22,083Useful dual stroke/TBI public-data signal; requires protocol-specific site feasibility.
Massachusetts General HospitalDRG 064: 181DRG 064: $19,889Appears in current US acute-ischemic-stroke trial activity on ClinicalTrials.gov; research activity strengthens — but does not establish — site candidacy.

AIRCHILL-STROKE site score

The working site score is now a staged qualification framework rather than a single volume rank:

20% CMS cerebrovascular signal20% EVT / LVO volume15% GA + invasive-ventilation eligible fraction15% active stroke-trial capability10% door-to-puncture workflow10% consent / emergency research readiness10% expected randomisations per centre-month

Protocol consequence: CMS 061–066 can identify where to ask the next question. They cannot supply the pivotal denominator. The run-in must record screened LVO, EVT, clinically indicated GA, exclusion, randomisation and treatment-start counts at each candidate centre.

Cardiac arrest · prevent a major denominator error

DRG 296 is not an OHCA market-size proxy.

In the 2024 CMS inpatient dataset, DRG 296 (“cardiac arrest, unexplained with MCC”) produced only five published hospital rows after CMS suppression of cells with 10 or fewer discharges. The returned values ranged from 11 to 15 discharges. That is useful as a narrow reimbursement observation, but it plainly cannot represent total OHCA or post-resuscitation hospital burden.

CMS rule

Use DRG 296 only as observed billing data

Never extrapolate national OHCA incidence, AIRCHILL eligibility or recruitment directly from this DRG.

Population model

Build the denominator outside the DRG

OHCA incidence → attempted resuscitation → sustained ROSC → unconscious → invasive ventilation → protocol timing → exclusions → randomisation.

Network model

Screen EMS research capability

ClinicalTrials.gov currently identifies US OHCA research activity including King County EMS, Hennepin Healthcare Research Institute and University of Pittsburgh emergency-medicine investigators/networks.

Economic model

Link outcomes to resource use

Observed inpatient payments are anchors; disability, rehabilitation, long-term care and survival/QALY scenarios remain separate model layers.

AIRCHILL-CA rule: site selection is EMS-catchment first, hospital second. The key operational metric is eligible randomisations per equipped ambulance/device-month, not hospital DRG count.

TBI & concussion · portfolio intelligence

Severe TBI is visible in inpatient CMS data; mild concussion often is not.

FY2024 MS-DRGs 082–087 classify traumatic stupor/coma by duration and complication level; 088–090 classify concussion. This creates a useful public-data split: severe TBI can support hospital-volume screening, while mild concussion requires outpatient/ED/epidemiologic sources because inpatient cells are sparse and suppressed.

DRG 082
367

Published 2024 hospital-DRG rows for traumatic stupor/coma >1 hour with MCC.

DRG 088
1

Only one published 2024 hospital row for concussion with MCC met the CMS publication threshold in this query — a strong warning against using inpatient CMS to size concussion burden.

Top returned DRG 082 example
61

Vanderbilt University Medical Center discharges; average Medicare payment about $17,769.

Research layer
308

ClinicalTrials.gov returned 308 US TBI studies in the current search universe, with 25 analysed in the first result batch and multiple active research sites.

DRG 082 example2024 dischargesAverage Medicare paymentInterpretation
Vanderbilt University Medical Center61$17,769Strong severe-TBI inpatient signal; also appears in active US stroke research networks.
Memorial Hermann Texas Medical Center57$23,627High severe-TBI signal and active acute-stroke research ecosystem.
Westchester Medical Center55$25,914High published Medicare severe-TBI signal.
Inova Fairfax Hospital54$20,515Cross-indication neuro-emergency signal in the public data.
NewYork-Presbyterian Hospital48$30,901High-acuity TBI signal plus active neurovascular research ecosystem.
Portfolio consequence: TBI should be maintained as a separate development hypothesis. These data justify where to investigate; they do not establish that respiratory cooling is effective in TBI or concussion.

Health economics

Every economic claim now has a declared layer.

A · Observed

CMS

Published discharges, submitted covered charges, total payments and Medicare payments, with reporting year, row grain and suppression caveat.

B · Trial observed

AIRCHILL clinical data

mRS/CPC, mortality, ICU and hospital days, ventilation, rehabilitation discharge, EQ-5D-5L and resource use collected prospectively.

C · Scenario

Outcome improvement

Prespecified +1/+3/+5 percentage-point or trial-derived outcome scenarios. These remain explicitly labelled assumptions until AIRCHILL clinical data replace them.

D · Model

Long-term value

QALYs, lifetime costs, rehabilitation, long-term care, productivity and payer-budget impact with sensitivity analysis.

No hidden conversion: CMS historical average payment is not a prospective fee schedule, not a hospital’s full economic cost and not the value of preventing disability. Each layer remains separately auditable.

Data refresh & provenance

Public-data pages are versioned, not treated as timeless facts.

  • CMS Medicare Inpatient Hospitals: reporting year 2024; dataset modification/publication used here: 23 April 2026; historical coverage available in the connector from 2013–2024.
  • CMS suppression: provider-DRG records with 10 or fewer discharges are excluded from the published hospital-DRG results.
  • ClinicalTrials.gov: registry activity is a research-capability signal, not proof of quality, eligibility or willingness to participate in AIRCHILL.
  • Refresh trigger: a new complete CMS reporting year, a material ClinicalTrials.gov network change, or a protocol version change triggers review of affected tables and site scores.
  • Change control: preserve the prior reporting year and document source date, methodology change and affected conclusions in the website change history.

Primary public sources

CMS Medicare Inpatient Hospitals – by Provider and Service →
CMS 2024 DRG 064 query →
CMS 2024 DRG 065 query →
CMS 2024 DRG 066 query →
CMS 2024 DRG 061 query →
CMS 2024 DRG 296 query →
CMS 2024 DRG 082 query →
ClinicalTrials.gov acute ischemic stroke search →
ClinicalTrials.gov OHCA search →
ClinicalTrials.gov TBI search →

Public CMS aggregate data do not contain patient-level records and are not medical advice, a coverage determination or government endorsement. Site examples are screening candidates only.