1. Circ Cardiovasc Qual Outcomes
Integrating Real-Time Clinical Information to Provide Estimates of Net Clinical Benefit of Antithrombotic Therapy for Patients With Atrial Fibrillation
by Mark H. Eckman, Ruth E. Wise, Barbara Speer, Megan Sullivan, Nita Walker, Gregory Y.H. Lip, Brett Kissela, Matthew L. Flaherty, Dawn Kleindorfer, Faisal Khan, John Kues, Peter Baker, Robert Ireton, Dave Hoskins, Brett M. Harnett, Carlos Aguilar, Anthony Leonard, Rajan Prakash, Lora Arduser, and Alexandru Costea
Circ Cardiovasc Qual Outcomes
Volume 7(5):
September 16, 2014
Copyright © American Heart Association, Inc. All rights reserved.

2. Distribution of stroke risk and bleeding risk scores among patients with atrial fibrillation in the primary care network.
Distribution of stroke risk and bleeding risk scores among patients with atrial fibrillation in the primary care network. Stroke and bleeding risk distributions across the 1876 active atrial fibrillation patients in the primary care network are described. ICH indicates intracerebral hemorrhage; and OAT, oral anticoagulant therapy.
Mark H. Eckman et al. Circ Cardiovasc Qual Outcomes. 2014;7:
Copyright © American Heart Association, Inc. All rights reserved.

3. Sample report from the Atrial Fibrillation Decision Support Tool (AFDST) for a patient with current treatment that is discordant with recommended treatment.
Sample report from the Atrial Fibrillation Decision Support Tool (AFDST) for a patient with current treatment that is discordant with recommended treatment. Top left, The patient’s name and medical record number. This 86-year-old woman currently receives aspirin. The 18 demographic and clinical variables used by the AFDST are shown in the 6×3 matrix. The bolded items represent those thought to be true based on data extracted from the atrial fibrillation (AF) data mart. For this patient, they are age ≥75 years, female sex, congestive heart failure (CHF), diabetes mellitus (DM), hypertension (HTN), vascular disease, and coronary artery disease, and she is taking nonsteroidal anti-inflammatory drugs. She has a CHA2DS2VASc score of 7, a CHADS2 score of 4, and an HAS-BLED score of 2, resulting, respectively, in a 9.6%/y rate of ischemic stroke without antithrombotic therapy, a 1.9%/y rate of major extracranial hemorrhage while receiving warfarin, and a 0.23%/y rate of intracerebral hemorrhage (ICH) while receiving warfarin. The AFDST projects quality-adjusted life expectancies of 5.26, 4.71, and 4.71 quality-adjusted life-years (QALYs) for warfarin, aspirin, and no antithrombotic therapy, respectively. Warfarin is the recommended therapy resulting in a clinically significant gain of 0.55 QALYs compared with either aspirin or no antithrombotic therapy. Top right, A concise summary of the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guideline for patients with AF. Because this patient has a CHA2DS2VASc score of 7, the guideline recommendation for such patients, highlighted in blue, is oral anticoagulant therapy with either warfarin (class I, level of evidence A) or one of the newer novel anticoagulants (class I, level of evidence B). CNS indicates central nervous system; ETOH, alcohol; Hx, history; MI, myocardial infarction; and RCT, randomized, controlled trial.
Mark H. Eckman et al. Circ Cardiovasc Qual Outcomes. 2014;7:
Copyright © American Heart Association, Inc. All rights reserved.