A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation
European Heart Journal, 07/03/2012
LaHaye SA et al. – The use of a clinical decision aid that considers both patient factors and evidence–based medicine will serve to bridge the knowledge gap and provide practical guidance to clinicians in the prevention of stroke due to atrial fibrillation.Methods
- The CHA2DS2–VASc and HAS–BLED scoring systems were used to assess patients’ baseline risks of stroke and major bleeding, respectively.
- The relative risks of stroke and major bleeding for each antithrombotic agent were then used to identify the agent associated with the lowest net risk.
- Individual patient factors such as the treatment threshold, bleeding ratio, and cost threshold modified the recommendations in order to generate a final recommendation.
- By considering both patient factors and clinical research concurrently, this clinical decision aid is able to provide specific advice to clinicians regarding an optimal stroke prevention strategy.
- The resulting treatment recommendation tables are consistent with the recommendations of the European Society of Cardiology and Canadian Cardiovascular Society Guidelines, which can be incorporated into either a paper–based or electronic format to allow clinicians to have decision support at the point of care.