Evidence map›Paper›PMID 32513116›Full record

Trial reportBMC family practice2020

Supporting anticoagulant treatment decision making to optimise stroke prevention in complex patients with atrial fibrillation: a cluster randomised trial.

Melina Gattellari, Andrew Hayen, Dominic Y C Leung, Nicholas A Zwar, John M Worthington

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 34% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
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

5 authors at 5 institutions in 1 country.

Melina GattellariDepartment of Neurology, Institute for Clinical Neurosciences, Neuroscience Research, Royal Prince Alfred Hospital, Missenden Road, Sydney Local Health District, Camperdown (Sydney), New South Wales, 2050, Australia. melina.gattellari@health.nsw.gov.au.
Andrew HayenFaculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, New South Wales, 2007, Australia.
Dominic Y C LeungSouth Western Sydney Clinical School UNSW, Liverpool, Australia.
Nicholas A ZwarFaculty of Health, Sciences and Medicine, Bond University, 14 University Drive, Robina, Queensland, 4226, Australia.
John M WorthingtonDepartment of Neurology, Institute for Clinical Neurosciences, Neuroscience Research, Royal Prince Alfred Hospital, Missenden Road, Sydney Local Health District, Camperdown (Sydney), New South Wales, 2050, Australia.
Bond University · AULiverpool Hospital · AURoyal Prince Alfred Hospital · AUSouth Western Sydney Local Health District · AUUniversity of Technology Sydney · AU

Funding

National Health and Medical Research Council Post-doctoral Training Fellowship 301136
6 · The paper itself

Abstract

backgroundAnticoagulation for preventing stroke in atrial fibrillation is under-utilised despite evidence supporting its use, resulting in avoidable death and disability. We aimed to evaluate an intervention to improve the uptake of anticoagulation.

methodsWe carried out a national, cluster randomised controlled trial in the Australian primary health care setting. General practitioners received an educational session, delivered via telephone by a medical peer and provided information about their patients selected either because they were not receiving anticoagulation or for whom anticoagulation was considered challenging. General practitioners were randomised to receive feedback from a medical specialist about the cases (expert decisional support) either before or after completing a post-test audit. The primary outcome was the proportion of patients reported as receiving oral anticoagulation. A secondary outcome assessed antithrombotic treatment as appropriate against guideline recommendations.

resultsOne hundred and seventy-nine general practitioners participated in the trial, contributing information about 590 cases. At post-test, 152 general practitioners (84.9%) completed data collection on 497 cases (84.2%). A 4.6% (Adjusted Relative Risk = 1.11, 95% CI = 0.86-1.43) difference in the post-test utilization of anticoagulation between groups was not statistically significant (p = 0.42). Sixty-one percent of patients in both groups received appropriate antithrombotic management according to evidence-based guidelines at post-test (Adjusted Relative Risk = 1.0; 95% CI = 0.85 to 1.19) (p = 0.97).

conclusionsSpecialist feed-back in addition to an educational session did not increase the uptake of anticoagulation in patients with AF.

trial registrationANZCTRN12611000076976 Retrospectively registered.

Indexed as

AnticoagulantsAtrial FibrillationGeneral PractitionersStrokeAdministration, OralAgedClinical Decision-MakingCluster AnalysisEducational MeasurementFemaleHumansMaleOutcome Assessment, Health CarePatient SelectionPrimary Health CareStaff DevelopmentAnticoagulantsAtrial fibrillationKnowledge translationStroke prevention

Identifiers

PMID32513116
PMCPMC7281948
OpenAlexW3033258263

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.