ArticleJournal of the American Geriatrics Society2016
Using an Atrial Fibrillation Decision Support Tool for Thromboprophylaxis in Atrial Fibrillation: Effect of Sex and Age.
Article in Journal of the American Geriatrics Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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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.
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.
Who cites it
9 citing papers in PubMed, 20 citations in OpenAlex.
- Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.BMJ quality & safety · 2019Trial
- Anticoagulant use in older persons at risk for falls: therapeutic dilemmas-a clinical review.European geriatric medicine · 2023Review
- Prescribing of anticoagulation for atrial fibrillation in primary care.Journal of thrombosis and thrombolysis · 2022Observational
- Digital Health Interventions to Enhance Prevention in Primary Care: Scoping Review.JMIR medical informatics · 2022Article
- Article
- Potentially inappropriate prescriptions of antithrombotic therapies in older outpatients: a French multicenter cross-sectional study.European geriatric medicine · 2019Article
- [Making balances between the risks and benefits of pharmacological treatment in dementia, chronic pain and anticoagulation in elderly persons].Atencion primaria · 2018Article
- Shared Decision-Making as the Future of Emergency Cardiology.The Canadian journal of cardiology · 2018Review
- Atrial fibrillation decision support tool: Population perspective.American heart journal · 2017Article
Corrections and comments
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Authors and funding
19 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesTo assess the appropriateness of oral anticoagulant therapy (OAT) in women and elderly adults, looking for patterns of undertreatment or unnecessary treatment.
designRetrospective cohort study.
settingPrimary care practices of an academic healthcare system.
participantsAdults (aged 28-93) with nonvalvular atrial fibrillation (AF) seen between March 2013 and February 2014 (N = 1,585). MEASUREMENTS: Treatment recommendations were made using an AF decision support tool (AFDST) based on projections of quality-adjusted life expectancy calculated using a decision analytical model that integrates individual-specific risk factors for stroke and hemorrhage.
resultsTreatment was discordant from AFDST-recommended treatment in 45% (326/725) of women and 39% (338/860) of men (P = .02). Although current treatment was discordant from recommended in 35% (89/258) of participants aged 85 and older and in 43% (575/1,328) of those younger than 85 (P = .01), many undertreated elderly adults were receiving aspirin as the sole antithrombotic agent.
conclusionPhysicians should understand that female sex is a significant risk factor for AF-related stroke and incorporate this into decision-making about thromboprophylaxis. Treating older adults with aspirin instead of OAT exposes them to significant risk of bleeding with little to no reduction in AF-related stroke risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.