Abstract
BACKGROUND: Acute Ischemic Stroke (AIS) remains a critical global health challenge that requires continuous improvement in diagnostic strategies. Timely and accurate diagnosis is essential for effective reperfusion therapies such as intravenous thrombolysis and mechanical thrombectomy, whose clinical benefits rapidly diminish with treatment delays. Artificial Intelligence (AI) offers promising potential to enhance diagnostic accuracy and clinical decision-making in AIS. However, data fragmentation and strict privacy regulations limit the development of robust AI systems. Objectives: We aim to provide a perspective-style review that explores how collaborative AI can reshape AIS diagnostics by overcoming data access barriers, fostering cross-institutional model development, and improving diagnostic equity. METHODS: We analysed current challenges in developing AIS-related AI tools, particularly the limitations caused by restricted data sharing across healthcare institutions. The study highlights collaborative AI approaches, such as federated learning and privacy-preserving computation, which enable decentralised model training while maintaining patient confidentiality. Relevant literature and recent developments in clinical AI collaboration were reviewed. RESULTS: Collaborative AI enables multiple institutions to contribute to model training without exposing raw patient data. This approach improves data diversity, model generalizability, and fairness across healthcare settings. Evidence from multi-centre studies suggests that collaborative AI frameworks can produce more accurate and ethically compliant diagnostic models compared to isolated development efforts. CONCLUSIONS: Collaborative AI presents a transformative pathway for AIS management by balancing data utility and privacy protection. It supports the creation of trustworthy, scalable, and inclusive diagnostic systems. As healthcare systems increasingly adopt digital solutions, collaborative AI provides a foundation for equitable and privacy-conscious innovation in stroke care.