Evidence map›Paper›PMID 40604463›Full record

Trial reportBMC primary care2025

Effect of a clinical decision support system for non-valvular atrial fibrillation on improving appropriate anticoagulation treatment in China's primary care: a cluster randomized controlled trial.

Xueying Ru, Tianhao Wang, Jian Gao, Junling Gao, Bin Kong, Qian Du, Yunhui Ma, Zhigang Pan

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. Review
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.

Xueying RuDepartment of Geriatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, 510000, China.
Tianhao WangDepartment of General Practice, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Jian GaoDepartment of General Practice, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Junling GaoPublic Health School, Fudan University, Shanghai, 200032, China.
Bin KongJingan Health Information Center, Shanghai, 200000, China.
Qian DuDepartment of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450052, China.
Yunhui MaDepartment of General Practice, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Zhigang PanDepartment of General Practice, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. zhigang_pan@163.com.

Funding

Zhongshan Hospital 2023ZSFZ03
6 · The paper itself

Abstract

aimsChina's primary care was required to improve the quality of atrial fibrillation (AF) management by government. The aim of the study was to investigate whether a clinical decision support system for non-valvular AF (GP-CDSS-2.0) affected appropriate anticoagulation of patients with AF in primary care. METHODS AND

resultsThe study was a cluster randomized controlled study, carried out in 13 community health centers in Shanghai, China, as 1 community health center in the intervention group withdraw the study. Patients with AF who consented to take part in and finish the follow-up were enrolled. We allocated the 14 community health centers into the intervention and control groups using stratified randomization method at a ratio of 1 to 1. General practitioners in the intervention group treated patients using GP-CDSS-2.0, while those in the control group provided usual care. The proportion of appropriate anticoagulation was the primary outcome. The secondary outcomes and safety outcomes mainly included the transition rate of patients' anticoagulation therapies and the incidences of bleeding and composite adverse outcomes. 405 patients were included in the analyses of primary outcome, with 182 in the intervention group and 223 in the control group. After 1 year's follow-up, the proportion of appropriate anticoagulation in the intervention group was higher than that in the control group (55.2% in the intervention group and 35.9% in the control group; relative risk (RR) = 1.441, 95% CI, 1.429-1.453, p < 0.001). The proportion of appropriate anticoagulation in the intervention group and the control group increased by 20% and 0.9%, respectively, compared with those at baseline (35.2% in the intervention group and 35.0% in the control group). More subjects in the intervention group experienced a correct transition of their anticoagulation therapies during the study (RR = 2.528, 95% CI, 1.276-5.008, p = 0.008). The intervention group showed a tendency of less bleeding and composite adverse outcomes.

conclusionsThe utilization of GP-CDSS-2.0 in primary care had the potential to raise the proportion of appropriate anticoagulation among patients with AF. Additionally, it could assist them in transitioning to proper anticoagulation treatments.

trial registrationRegistration Number ChiCTR2100052307. Registration Date 22/11/2021.

Indexed as

AnticoagulantsAtrial FibrillationDecision Support Systems, ClinicalPrimary Health CareAgedChinaFemaleHemorrhageHumansMaleMiddle AgedAnticoagulantsAtrial fibrillationClinical decision support systemCluster randomized controlled trialGuideline compliancePrimary care

Identifiers

PMID40604463
PMCPMC12217383

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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.