ArticleEuropean heart journal. Digital health2025
Cost-effectiveness of a clinical decision support system for atrial fibrillation: an RCT-based modelling study.
Article in European heart journal. Digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02635685 (Clinical Decision Support for Stroke Prevention in Atrial Fibrillation - a Cluster Randomized Trial in the Primary Care Setting), which is not on this map. Cited by 1 paper.
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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.
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.
Clinical Decision Support for Stroke Prevention in Atrial Fibrillation - a Cluster Randomized Trial in the Primary Care Setting
Who cites it
1 citing paper in PubMed.
- Qualitative Evaluation of a Clinical Decision-Support Tool for Improving Anticoagulation Control in Non-Valvular Atrial Fibrillation in Primary Care.Healthcare (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aims: Atrial fibrillation (AF) is a common arrythmia that increases the risk of thromboembolism. Despite the effectiveness of anticoagulation in AF, underuse remains a substantial problem. Clinical decision support (CDS) systems may increase adherence to guideline recommended anticoagulation in AF. However, evidence regarding the cost-effectiveness of these interventions is lacking. The aim of this study was therefore to evaluate the cost-effectiveness of a CDS for AF. Methods and results: We developed a disease progression model with a Markov structure and simulated a cohort of hypothetical individuals with AF through a standard of care and a CDS strategy. The adherence to anticoagulation in the model was based on the treatment effect reported in the CDS-AF trial, which evaluated the effect of a CDS in patients with AF in the primary care in Östergötland, Sweden. The cost-effectiveness of the CDS-AF intervention compared with standard of care was determined by estimating costs and quality-adjusted life years (QALYs) gained over a lifetime time horizon and was reported as an incremental cost-effectiveness ratio (ICER) assessed against a decision-threshold of €50 000. Uncertainty was evaluated using both one-way and probabilistic sensitivity analysis (PSA). The CDS-intervention resulted in fewer ischaemic strokes but more bleedings. The mean per patient gain in QALYs was 0.012 and the ICER was €963 per QALY gained. The result of the PSA indicated a high probability that the ICER was below €50 000. Conclusion: The CDS intervention used in the CDS-AF trial appears to yield health gains at a lower cost than typically considered cost-effective. Trial registration: NCT02635685.
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