Evidence map›Paper›PMID 38807186›Full record

ReviewThrombosis journal2024

Clinical decision support systems to optimize adherence to anticoagulant guidelines in patients with atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.

Ahmed Mazen Amin, Ramy Ghaly, Mohamed T Abuelazm, Ahmed A Ibrahim, Mohammad Tanashat, Moumen Arnaout, Obieda Altobaishat, Ahmed Elshahat, Basel Abdelazeem, Sudarshan Balla

Abstract readReview
In one paragraph

Review in Thrombosis journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Adherence to oral thromboprophylaxis in atrial fibrillation: an overview for clinicians.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 · 2025
    Review
  4. Article
  5. 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.

Ahmed Mazen AminFaculty of Medicine, Mansoura University, Mansoura, Egypt. ahmedmazenali@std.mans.edu.eg.
Ramy GhalyInternal Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.
Mohamed T AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.
Ahmed A IbrahimFaculty of Medicine, Menoufia University, Menoufia, Egypt.
Mohammad TanashatFaculty of Medicine, Yarmouk University, Irbid, Jordan.
Moumen ArnaoutFaculty of Medicine, Aleppo University, Aleppo, Syria.
Obieda AltobaishatFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Ahmed ElshahatFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Basel AbdelazeemDepartment of Cardiology, West Virginia University, Morgantown, WV, USA.
Sudarshan BallaDepartment of Cardiology, West Virginia University, Morgantown, WV, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical decision support systems (CDSS) have been utilized as a low-cost intervention to improve healthcare process measures. Thus, we aim to estimate CDSS efficacy to optimize adherence to oral anticoagulant guidelines in eligible patients with atrial fibrillation (AF).

methodsA systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through August 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) with a 95% confidence interval (CI). PROSPERO ID: CRD42023471806.

resultsWe included nine RCTs with a total of 25,573 patients. There was no significant difference, with the use of CDSS compared to routine care, in the number of patients prescribed anticoagulants (RR: 1.06, 95% CI [0.98, 1.14], P = 0.16), the number of patients prescribed antiplatelets (RR: 1.01 with 95% CI [0.97, 1.06], P = 0.59), all-cause mortality (RR: 1.19, 95% CI [0.31, 4.50], P = 0.80), major bleeding (RR: 0.84, 95% CI [0.21, 3.45], P = 0.81), and clinically relevant non-major bleeding (RR: 1.05, 95% CI [0.52, 2.16], P = 0.88). However, CDSS was significantly associated with reduced incidence of myocardial infarction (RR: 0.18, 95% CI [0.06, 0.54], P = 0.002) and cerebral or systemic embolic event (RR: 0.11, 95% CI [0.01, 0.83], P = 0.03).

conclusionWe report no significant difference with the use of CDSS compared to routine care in anticoagulant or antiplatelet prescription in eligible patients with AF. CDSS was associated with a reduced incidence of myocardial infarction and cerebral or systemic embolic events.

Indexed as

Atrial fibrillationElectronic alerts.Electronic notificationsOral anticoagulation

Identifiers

PMID38807186
PMCPMC11134712

What OpenQuestion holds

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LicenceCC BY
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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.