{"id":"https://openalex.org/W2893569293","doi":"https://doi.org/10.7326/m17-2762","title":"Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation","display_name":"Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation","publication_year":2018,"publication_date":"2018-09-25","ids":{"openalex":"https://openalex.org/W2893569293","doi":"https://doi.org/10.7326/m17-2762","mag":"2893569293","pmid":"https://pubmed.ncbi.nlm.nih.gov/30264130"},"language":"en","primary_location":{"id":"doi:10.7326/m17-2762","doi":"https://doi.org/10.7326/m17-2762","is_oa":false,"landing_page_url":"https://doi.org/10.7326/m17-2762","pdf_url":null,"source":{"id":"https://openalex.org/S119722071","display_name":"Annals of Internal Medicine","issn_l":"0003-4819","issn":["0003-4819","1539-3704"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316812","host_organization_name":"American College of Physicians","host_organization_lineage":["https://openalex.org/P4310316812"],"host_organization_lineage_names":["American College of Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of Internal Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5028402333","display_name":"Sachin J. Shah","orcid":"https://orcid.org/0000-0001-8400-6888","observed_orcids":["https://orcid.org/0000-0001-8400-6888"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sachin J. Shah","raw_affiliation_strings":["University of California, San Francisco, San Francisco, California (S.J.S.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of California, San Francisco, San Francisco, California (S.J.S.)","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091740246","display_name":"Mark H. Eckman","orcid":"https://orcid.org/0000-0001-8253-269X","observed_orcids":["https://orcid.org/0000-0001-8253-269X"]},"institutions":[{"id":"https://openalex.org/I63135867","display_name":"University of Cincinnati","ror":"https://ror.org/01e3m7079","country_code":"US","type":"education","lineage":["https://openalex.org/I63135867"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mark H. Eckman","raw_affiliation_strings":["University of Cincinnati College of Medicine, Cincinnati, Ohio (M.H.E.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Cincinnati College of Medicine, Cincinnati, Ohio (M.H.E.)","institution_ids":["https://openalex.org/I63135867"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007570018","display_name":"Sara Aspberg","orcid":"https://orcid.org/0000-0003-3467-759X","observed_orcids":["https://orcid.org/0000-0003-3467-759X"]},"institutions":[{"id":"https://openalex.org/I28166907","display_name":"Karolinska Institutet","ror":"https://ror.org/056d84691","country_code":"SE","type":"education","lineage":["https://openalex.org/I28166907"]}],"countries":["SE"],"is_corresponding":false,"raw_author_name":"Sara Aspberg","raw_affiliation_strings":["Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)","institution_ids":["https://openalex.org/I28166907"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5026846209","display_name":"Alan S. Go","orcid":"https://orcid.org/0000-0001-9109-0811","observed_orcids":["https://orcid.org/0000-0001-9109-0811","https://orcid.org/0000-0001-5671-0763"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]},{"id":"https://openalex.org/I4405284138","display_name":"Kaiser Permanente Northern California","ror":"https://ror.org/0302f6d89","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1343052199","https://openalex.org/I4405284138"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Alan S. Go","raw_affiliation_strings":["University of California, San Francisco, San Francisco, and Kaiser Permanente Northern California, Oakland, California (A.S.G.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of California, San Francisco, San Francisco, and Kaiser Permanente Northern California, Oakland, California (A.S.G.)","institution_ids":["https://openalex.org/I180670191","https://openalex.org/I4405284138"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5020290782","display_name":"Daniel E. Singer","orcid":"https://orcid.org/0000-0001-6145-4848","observed_orcids":["https://orcid.org/0000-0001-6145-4848"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Daniel E. Singer","raw_affiliation_strings":["Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (D.E.S.)"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (D.E.S.)","institution_ids":["https://openalex.org/I136199984","https://openalex.org/I4210087915"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":6,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":2.9341,"has_fulltext":false,"cited_by_count":25,"citation_normalized_percentile":{"value":0.92289382,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":92,"max":98},"biblio":{"volume":"169","issue":"8","first_page":"517","last_page":"527"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10065","display_name":"Atrial Fibrillation Management and Outcomes","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10065","display_name":"Atrial Fibrillation Management and Outcomes","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10227","display_name":"Acute Ischemic Stroke Management","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10285","display_name":"Venous Thromboembolism Diagnosis and Management","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2724","display_name":"Internal Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/atrial-fibrillation","display_name":"atrial fibrillation","score":0.9539999961853027},{"id":"https://openalex.org/keywords/stroke-rate","display_name":"stroke rate","score":0.7099999785423279},{"id":"https://openalex.org/keywords/anticoagulation","display_name":"anticoagulation","score":0.9509999752044678},{"id":"https://openalex.org/keywords/net-clinical-benefit","display_name":"net clinical benefit","score":0.8420000076293945},{"id":"https://openalex.org/keywords/cha2ds2-vasc-score","display_name":"CHA2DS2-VASc score","score":0.9539999961853027},{"id":"https://openalex.org/keywords/warfarin","display_name":"warfarin","score":0.9350000023841858},{"id":"https://openalex.org/keywords/direct-oral-anticoagulants","display_name":"direct oral anticoagulants","score":0.996999979019165},{"id":"https://openalex.org/keywords/quality-adjusted-life-years","display_name":"quality-adjusted life years","score":0.9010000228881836},{"id":"https://openalex.org/keywords/intracranial-hemorrhage","display_name":"intracranial hemorrhage","score":0.9399999976158142}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9697742462158203},{"id":"https://openalex.org/C2779161974","wikidata":"https://www.wikidata.org/wiki/Q815819","display_name":"Atrial fibrillation","level":2,"score":0.9068986177444458},{"id":"https://openalex.org/C2780645631","wikidata":"https://www.wikidata.org/wiki/Q671554","display_name":"Stroke (engine)","level":2,"score":0.7370185852050781},{"id":"https://openalex.org/C2776301958","wikidata":"https://www.wikidata.org/wiki/Q407431","display_name":"Warfarin","level":3,"score":0.7367808222770691},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6220282316207886},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.5005965232849121},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.47636696696281433},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.43440693616867065},{"id":"https://openalex.org/C2778198053","wikidata":"https://www.wikidata.org/wiki/Q181754","display_name":"Heart failure","level":2,"score":0.414399117231369},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0},{"id":"https://openalex.org/C78519656","wikidata":"https://www.wikidata.org/wiki/Q101333","display_name":"Mechanical engineering","level":1,"score":0.0},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000925","descriptor_name":"Anticoagulants","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D001281","descriptor_name":"Atrial Fibrillation","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008390","descriptor_name":"Markov Chains","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012307","descriptor_name":"Risk Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018570","descriptor_name":"Risk Assessment","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019057","descriptor_name":"Quality-Adjusted Life Years","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D020521","descriptor_name":"Stroke","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D020521","descriptor_name":"Stroke","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.7326/m17-2762","doi":"https://doi.org/10.7326/m17-2762","is_oa":false,"landing_page_url":"https://doi.org/10.7326/m17-2762","pdf_url":null,"source":{"id":"https://openalex.org/S119722071","display_name":"Annals of Internal Medicine","issn_l":"0003-4819","issn":["0003-4819","1539-3704"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316812","host_organization_name":"American College of Physicians","host_organization_lineage":["https://openalex.org/P4310316812"],"host_organization_lineage_names":["American College of Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of Internal Medicine","raw_type":"journal-article"},{"id":"pmid:30264130","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30264130","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annals of internal medicine","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G8701320340","display_name":"Cincinnati Center for Clinical and Translational Sciences and Training","funder_award_id":"UL1TR000077","funder_id":"https://openalex.org/F4320332161","funder_display_name":"National Institutes of Health"}],"funders":[{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337472","display_name":"National Center for Advancing Translational Sciences","ror":"https://ror.org/04pw6fb54"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":46,"referenced_works":["https://openalex.org/W1508825876","https://openalex.org/W1522894564","https://openalex.org/W1556538175","https://openalex.org/W1993614294","https://openalex.org/W1999468381","https://openalex.org/W2022095549","https://openalex.org/W2024791905","https://openalex.org/W2031990245","https://openalex.org/W2045093798","https://openalex.org/W2045913143","https://openalex.org/W2060630424","https://openalex.org/W2064836413","https://openalex.org/W2066157763","https://openalex.org/W2067443499","https://openalex.org/W2070455408","https://openalex.org/W2078414845","https://openalex.org/W2083723075","https://openalex.org/W2094597275","https://openalex.org/W2101501864","https://openalex.org/W2112439830","https://openalex.org/W2115684044","https://openalex.org/W2121394112","https://openalex.org/W2124601103","https://openalex.org/W2127985968","https://openalex.org/W2128106558","https://openalex.org/W2135540660","https://openalex.org/W2144891869","https://openalex.org/W2152623033","https://openalex.org/W2152647843","https://openalex.org/W2154328340","https://openalex.org/W2158311202","https://openalex.org/W2162586165","https://openalex.org/W2165762371","https://openalex.org/W2166503147","https://openalex.org/W2171868042","https://openalex.org/W2291314303","https://openalex.org/W2472261290","https://openalex.org/W2509795914","https://openalex.org/W2540928320","https://openalex.org/W2546446487","https://openalex.org/W2805795477","https://openalex.org/W3004050106","https://openalex.org/W4205645630","https://openalex.org/W4206535002","https://openalex.org/W4240271001","https://openalex.org/W4243375272"],"related_works":["https://openalex.org/W2952290559","https://openalex.org/W2948247627","https://openalex.org/W2540928320","https://openalex.org/W1978901267","https://openalex.org/W2941671763","https://openalex.org/W2165762371","https://openalex.org/W1556538175","https://openalex.org/W4410696910","https://openalex.org/W2144891869","https://openalex.org/W1983445218"],"abstract_inverted_index":{"Background:":[0],"Stroke":[1],"rates":[2,46,130,179,226,257],"in":[3,31,42,73,207,253,265,268,281],"patients":[4,125,259],"with":[5,84],"nonvalvular":[6],"atrial":[7,208],"fibrillation":[8],"(AF)":[9],"who":[10],"are":[11],"not":[12,246,260],"receiving":[13,261],"anticoagulant":[14,262],"therapy":[15,263],"vary":[16],"widely":[17],"across":[18],"published":[19,43,254],"studies;":[20],"the":[21,25,38,48,61,93,132,147,188,199,218,269,279],"resulting":[22],"effect":[23,39],"on":[24,47],"net":[26,49,270],"clinical":[27,50,271],"benefit":[28,51,119,244,272],"of":[29,40,52,113,120,227,273,284],"anticoagulation":[30,122,172],"AF":[32,44,190,255],"is":[33],"unknown.":[34],"Objective:":[35],"To":[36],"determine":[37],"variation":[41,267],"stroke":[45,129,178,256,285],"anticoagulation.":[53,274,290],"Design:":[54],"Markov":[55],"model":[56],"decision":[57],"analysis.":[58,76],"Warfarin":[59],"was":[60,126,173],"base":[62],"case,":[63],"and":[64,109,135,142,211],"non-vitamin":[65],"K":[66],"antagonist":[67],"oral":[68],"anticoagulants":[69],"(NOACs)":[70],"were":[71],"modeled":[72],"a":[74,100],"secondary":[75],"Setting:":[77],"Community-dwelling":[78],"adults.":[79],"Patients:":[80],"33":[81,94],"434":[82,95],"adults":[83],"incident":[85],"AF.":[86],"Measurements:":[87],"Quality-adjusted":[88],"life-years":[89],"(QALYs).":[90],"Results:":[91],"Of":[92],"patients,":[96],"27":[97],"179":[98],"had":[99],"CHA2DS2-VASc":[101,168,233],"(congestive":[102],"heart":[103],"failure,":[104],"hypertension,":[105],"age,":[106],"diabetes,":[107],"stroke,":[108],"vascular":[110],"disease)":[111],"score":[112,169,234,287],"2":[114,182],"or":[115,175,183,194,213],"more.":[116],"The":[117,166],"population":[118],"warfarin":[121],"for":[123,171,224,258,288],"these":[124,237],"least":[127],"using":[128,144,177,185,196,203,215],"from":[131,146,180,187,198,217],"ATRIA":[133],"(AnTicoagulation":[134],"Risk":[136],"Factors":[137],"In":[138],"Atrial":[139],"Fibrillation)":[140,209],"study":[141],"greatest":[143],"those":[145,186,197,216],"Danish":[148,219],"National":[149,220],"Patient":[150,221],"Registry":[151],"(6290":[152],"QALYs":[153,160],"[95%":[154],"CI,":[155],"\u00b12.3%]":[156],"vs.":[157],"24":[158],"110":[159],"[CI,":[161],"\u00b11.9%];":[162],"P":[163],"<":[164],"0.001).":[165],"optimal":[167,232],"threshold":[170],"3":[174],"more":[176,184,195,214],"ATRIA,":[181],"Swedish":[189],"cohort":[191],"study,":[192,210],"1":[193],"SPORTIF":[200],"(Stroke":[201],"Prevention":[202],"ORal":[204],"Thrombin":[205],"Inhibitor":[206],"0":[212],"Registry.":[222],"Accounting":[223],"lower":[225],"NOAC-associated":[228],"intracranial":[229],"hemorrhage":[230],"decreased":[231],"thresholds,":[235],"but":[236],"thresholds":[238,283],"still":[239],"varied":[240],"widely.":[241],"Limitation:":[242],"Measured":[243],"may":[245],"generalize":[247],"to":[248],"other":[249],"populations.":[250],"Conclusion:":[251],"Variation":[252],"results":[264],"multifold":[266],"Guidelines":[275],"should":[276],"better":[277],"reflect":[278],"uncertainty":[280],"current":[282],"risk":[286],"recommending":[289],"Primary":[291],"Funding":[292],"Source:":[293],"None.":[294]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2024,"cited_by_count":2},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":3},{"year":2021,"cited_by_count":3},{"year":2020,"cited_by_count":5},{"year":2019,"cited_by_count":6},{"year":2018,"cited_by_count":2}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2018-10-05T00:00:00"}