Evidence map›Paper›PMID 16129870›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2005

Impact of a patient decision aid on care among patients with nonvalvular atrial fibrillation: a cluster randomized trial.

Finlay A McAlister, Malcolm Man-Son-Hing, Sharon E Straus, William A Ghali, David Anderson, Sumit R Majumdar, Paul Gibson, Jafna L Cox, Miriam Fradette, Decision Aid in Atrial Fibrillation (DAAFI) Investigators

Abstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  3. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024
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  6. Patient-mediated interventions to improve professional practice.The Cochrane database of systematic reviews · 2018
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  7. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Finlay A McAlisterDivision of General Internal Medicine, University of Alberta, Edmonton, Alta. Finlay.McAlister@ualberta.ca
Malcolm Man-Son-Hing
Sharon E Straus
William A Ghali
David Anderson
Sumit R Majumdar
Paul Gibson
Jafna L Cox
Miriam Fradette
Decision Aid in Atrial Fibrillation (DAAFI) Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundToo few patients with nonvalvular atrial fibrillation (NVAF) receive appropriate antithrombotic therapy. We tested the short-term (primary outcome) and long-term (secondary outcome) effect of a patient decision aid on the appropriateness of antithrombotic therapy among patients with NVAF.

methodsWe conducted a cluster randomized trial with blinded outcome assessment involving 434 NVAF patients from 102 community-based primary care practices. Patients in the intervention group received a self-administered booklet and audiotape decision aid tailored to their personal stroke risk profile. Patients in the control group received usual care. The primary outcome measure was change in antithrombotic therapy at 3 months. Appropriateness of therapy was defined using the American College of Chest Physicians (ACCP) recommendations.

resultsThe mean patient age was 72 years, and the median duration of NVAF was 5 years. In the control group, there was a 3% decrease over 3 months in the number of patients receiving therapy appropriate to their risk of stroke (40% [85/215] at baseline v. 37% [79/215] at 3 months). In the intervention group, the number of patients receiving therapy appropriate to their stroke risk increased by 9% (32% [69/219] at baseline v. 41% [89/219] at 3 months). Although the proportion of patients whose therapy met the ACCP treatment recommendations did not differ between study arms at baseline (p = 0.11) or 3 months (p = 0.44), there was a 12% absolute improvement in the number of patients receiving appropriate care in the intervention group compared with the control group at 3 months (p = 0.03). The beneficial effect of the decision aid did not persist (p = 0.44 for differences between study arms after 12 months).

interpretationThere was short-term improvement in the appropriateness of antithrombotic care among patients with NVAF who were exposed to a decision aid, but the improvement did not persist.

Indexed as

Decision Support Systems, ClinicalPatient Education as TopicAgedAtrial FibrillationFemaleFibrinolytic AgentsHumansMalePrimary Health CareRisk FactorsStrokeTreatment OutcomeFibrinolytic Agents

Identifiers

PMID16129870
PMCPMC1188186

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.