Evidence map›Paper›PMID 31753872›Full record

ArticleBMJ open2019

Temporal variation in the diagnosis of resolved atrial fibrillation and the influence of performance targets on clinical coding: cohort study.

Nicola Adderley, Krishnarajah Nirantharakumar, Tom Marshall

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 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 35% 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. 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

3 authors at 1 institution in 1 country.

Nicola AdderleyInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID 0000-0003-0543-3254
Krishnarajah NirantharakumarInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Tom MarshallInstitute of Applied Health Research, University of Birmingham, Birmingham, UK t.p.marshall@bham.ac.uk.
University of Birmingham · GB

Funding

Medical Research Council MR/S003878/1
6 · The paper itself

Abstract

objectivesTo investigate whether the introduction of performance targets for anticoagulation in atrial fibrillation (AF) was associated with a change in use of the 'resolved AF' code.

designRetrospective cohort studies.

settingData from The Health Improvement Network, a UK database of electronic patient records, from 2000 to 2016.

participants250 788 adult patients aged ≥18 years with a diagnosis of AF, including 14 757 with an incident diagnosis of 'resolved AF'.

main outcome measuresAnnual and monthly incidence of 'resolved AF' from 2000 to 2016. Among patients with 'resolved AF', for each year we calculated median duration of the preceding AF diagnosis and the proportion prescribed anticoagulants prior to 'resolved AF'.

resultsIncidence of 'resolved AF' increased from 5.7 to 26.3 per 1000 person-years between 2005 and the introduction of AF performance targets in 2006. Compared with the years prior to the introduction of the performance targets, incidence has remained higher in every year since their implementation. Since 2007, monthly incidence has been highest between January and March. Between 2005 and 2006, median duration between AF and 'resolved AF' diagnoses increased from 276 days (9 months) to 1343 days (3 years 8 months). Among 'resolved AF' patients with CHA

conclusionThe introduction of AF performance targets was followed by a large increase in use of the 'resolved AF' code, particularly in the months immediately before practices make their anticoagulant performance target submissions. Although most AF patients are prescribed anticoagulants, few patients diagnosed with 'resolved AF' are prescribed anticoagulants and most have never been prescribed them. Untreated patients are much more likely to be coded as having 'resolved AF'.

Indexed as

Clinical CodingAgedAnticoagulantsAtrial FibrillationCohort StudiesFemaleHumansIncidenceMaleMiddle AgedPeriodicityPractice Patterns, Physicians'Retrospective StudiesUnited KingdomAnticoagulantsanticoagulationcardiologyprimary care

Identifiers

PMID31753872
PMCPMC6887086
OpenAlexW2991080127

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.