Evidence map›Paper›PMID 30671252›Full record

ArticleCanadian journal of kidney health and disease2019

Canadian Nephrologist Views Regarding Stroke and Systemic Embolism Prevention in Dialysis Patients With Nonvalvular Atrial Fibrillation: A Survey.

David Collister, Jeff S Healey, David Conen, K Scott Brimble, Claudio Rigatto, Ziv Harel, Manish M Sood, Michael Walsh

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of kidney health and disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Stroke Subtype Among Individuals With Chronic Kidney Disease.Canadian journal of kidney health and disease · 2023
    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

8 authors at 5 institutions in 1 country.

David CollisterDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Jeff S HealeyPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
David ConenPopulation Health Research Institute, McMaster University, Hamilton, ON, Canada.
K Scott BrimbleDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Claudio RigattoDivision of Nephrology, Department of Medicine, University of Manitoba, Winnipeg, Canada.
Ziv HarelDivision of Nephrology, Department of Medicine, University of Toronto, ON, Canada.
Manish M SoodDivision of Nephrology, Department of Medicine, University of Ottawa, ON, Canada.
Michael WalshDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Population Health Research Institute · CAMcMaster University · CAUniversity of Manitoba · CAUniversity of Ottawa · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNonvalvular atrial fibrillation (NVAF) is an independent risk factor for ischemic stroke and is common in chronic kidney disease (CKD) and dialysis patients. The use of oral anticoagulation to prevent stroke and systemic embolism in the setting of kidney disease is controversial. Novel alternatives to vitamin K antagonists include left atrial appendage occlusion devices (LAAOD) and apixaban.

objectiveWe sought to elicit Canadian nephrologist views regarding stroke and systemic embolism prevention therapies in CKD and dialysis patients with NVAF.

designSurvey.

settingOnline via https://www.surveymonkey.com.

participantsCanadian Society of Nephrology members actively treating adult dialysis patients with NVAF. MEASUREMENTS: Management questions were asked with response options consisting of a Likert scale ranging from 1 to 8 (with 1 being

methodsWe randomly allocated each respondent to 2 of 4 cases that varied by stroke and bleeding risks (using varying CHADS2 and HASBLED scores, respectively).

resultsThere were 91 responses (36.3% response rate) from mostly university (83.5%) and also community with university affiliation (12.1%) and community (4.4%) nephrologists. Warfarin was more likely to be recommended in individuals at high stroke risk and low bleeding risk (mean = 5.47, 95% confidence interval = 4.87-6.07) and less likely to be recommended in individuals at moderate stroke risk and high bleeding risk (mean = 2.89, 95% confidence interval = 2.37-3.41). The likelihood of recommending LAAOD did not vary by stroke or bleeding risks (means ranging from 3.92-4.90). Apixaban was not likely to be recommended in any case (means ranging from 2.60-3.50). However, nephrologists felt there was equipoise regarding anticoagulation strategies allowing participation in appropriate randomized controlled trials (RCTs). LIMITATIONS: The survey only involved nephrologists and only 4 cases with dichotomized risk categories were presented instead of complete range of stroke and bleeding risk combinations. As with any survey, there was the potential for responder bias and treatment decisions are not anchored directly to patient management.

conclusionsNephrologists caring for patients with kidney disease appear willing to include patients in clinical trials examining alternatives to warfarin for stroke and systemic embolism prevention for NVAF in the setting of kidney disease.

Indexed as

atrial fibrillationdialysispreventionstroke

Identifiers

PMID30671252
PMCPMC6327328
OpenAlexW2908807534

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.