Evidence map›Paper›PMID 26811169›Full record

Trial reportJournal of the American Heart Association2016

An Integrated Management Approach to Atrial Fibrillation.

Lindsey Carter, Martin Gardner, Kirk Magee, Ann Fearon, Inna Morgulis, Steve Doucette, John L Sapp, Chris Gray, Amir Abdelwahab, Ratika Parkash

Abstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 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

34 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Clinical service organisation for adults with atrial fibrillation.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Effect of targeted education of patients with atrial fibrillation on unplanned cardiovascular outcomes: results of the multicentre randomized AF-EduCare trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Trial
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Article
  11. Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025
    Article
  12. Article
  13. Article
  14. Review
  15. Impact of lifestyle risk factors on atrial fibrillation: Mechanisms and prevention approaches - A narrative review.International journal of cardiology. Cardiovascular risk and prevention · 2024
    Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
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.

Lindsey CarterDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Martin GardnerDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Kirk MageeDepartment of Emergency Medicine, QEII Health Sciences Center, Halifax, Canada (K.M.).
Ann FearonDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Inna MorgulisDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Steve DoucetteResearch Methods Unit, Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada (S.D.).
John L SappDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Chris GrayDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Amir AbdelwahabDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).
Ratika ParkashDepartment of Medicine, QEII Health Sciences Center, Halifax, Canada (L.C., M.G., A.F., I.M., J.L.S., C.G., A.A., R.P.).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia resulting in mortality and morbidity. Gaps in oral anticoagulation and education of patients regarding AF have been identified as areas that require improvement. METHODS AND

resultsA before-and-after study of 433 patients with newly diagnosed AF in the 3 emergency departments in Nova Scotia from January 1, 2011 until January 31, 2014 was performed. The "before" phase underwent the usual-care pathway for AF management; the "after" phase was enrolled in a nurse-run, physician-supervised AF clinic. The primary outcome was a composite of death, cardiovascular hospitalization, and AF-related emergency department visits. A propensity analysis was performed to account for differences in baseline characteristics.

resultsA total of 185 patients were enrolled into the usual-care group, and 228 patients were enrolled in the AF clinic group. The mean age was 64±15 years and 44% were women. In a propensity-matched analysis, the primary outcome occurred in 44 (26.2%) patients in the usual-care group and 29 (17.3%) patients in the AF clinic group (odds ratio 0.71; 95% CI [0.59, 1]; P=0.049) at 12 months. Prescription of oral anticoagulation was increased in the CHADS2 ≥2 group (88.4% in the AF clinic versus 58.5% in the usual-care group, P<0.01).

conclusionsAdoption of this integrated management approach for the burgeoning population of AF may provide an overall benefit to cardiovascular morbidity and mortality.

Indexed as

Delivery of Health Care, IntegratedOutpatient Clinics, HospitalAdministration, OralAgedAnticoagulantsAtrial FibrillationCooperative BehaviorEmergency Service, HospitalFemaleHospitalizationHumansInterdisciplinary CommunicationMaleMiddle AgedNova ScotiaOdds RatioAnticoagulantsatrial fibrillationquality and outcomes

Identifiers

PMID26811169
PMCPMC4859404

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.