Article
Medicine, General & Internal
Celia C. Kamath, Rachel Giblon, Marlene Kunneman, Alexander I. Lee, Megan E. Branda, Ian G. Hargraves, Angela L. Sivly, Fernanda Bellolio, Elizabeth A. Jackson, Bruce Burnett, Haeshik Gorr, Victor D. Torres Roldan, Gabriella Spencer-Bonilla, Nilay D. Shah, Peter A. Noseworthy, Victor M. Montori, Juan P. Brito
Summary: The study found that conversations about the costs of anticoagulants for atrial fibrillation were common between patients and clinicians, especially for middle-income patients and with female and consultant-level primary care clinicians. These conversations were associated with patients' consideration of treatment cost burden but did not influence the final treatment choice.
Article
Cardiac & Cardiovascular Systems
Roopinder K. Sandhu, Stephen B. Wilton, Sunjiduatul Islam, Clare L. Atzema, Mark Deyell, D. George Wyse, Jafna L. Cox, Allan Skanes, Padma Kaul
Summary: Based on Canadian health information, the hospitalization rates for incident NVAF/AFL showed a declining trend from 2006 to 2015 both nationally and provincially. The majority of hospitalized patients were at high risk for stroke, which remained unchanged. Although in-hospital mortality has decreased, it continues to be a significant issue.
CANADIAN JOURNAL OF CARDIOLOGY
(2021)
Article
Clinical Neurology
Takeshi Yoshimoto, Kazunori Toyoda, Masafumi Ihara, Hiroshi Inoue, Takeshi Yamashita, Shinya Suzuki, Masaharu Akao, Hirotsugu Atarashi, Takanori Ikeda, Ken Okumura, Yukihiro Koretsune, Wataru Shimizu, Hiroyuki Tsutsui, Atsushi Hirayama, Masahiro Yasaka, Hirofumi Maruyama, Satoshi Teramukai, Tetsuya Kimura, Yoshiyuki Morishima, Atsushi Takita, Takenori Yamaguchi
Summary: The history of stroke/TIA in elderly patients increases the risk of stroke, bleeding, and death. Among patients with prior ischemic stroke/TIA, taking direct oral anticoagulants reduces the risk of bleeding events.
Article
Pharmacology & Pharmacy
Clara L. Rodriguez-Bernal, Francisco Sanchez-Saez, Daniel Bejarano-Quisoboni, Judit Riera-Arnau, Gabriel Sanfelix-Gimeno, Isabel Hurtado
Summary: Despite continuous updates of clinical guidelines, real-world data from a large population-based cohort in the Valencia region, Spain, revealed that nearly 30% of AF stroke survivors were untreated or received antiplatelet therapy, posing a risk due to therapeutic inertia and delayed treatment initiation.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Medicine, General & Internal
Jacopo Francesco Imberti, Davide Antonio Mei, Marco Vitolo, Niccolo Bonini, Marco Proietti, Tatjana Potpara, Gregory Y. H. Lip, Giuseppe Boriani
Summary: Clinical practice in atrial fibrillation patient management is constantly evolving. Various new guidelines have been published in the past few years, and they differ in key elements such as thromboembolic risk assessment, oral anticoagulants prescription, bleeding risk evaluation, and integrated patient management. The importance of an integrated and multidisciplinary approach to patient care is emerging.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2022)
Article
Clinical Neurology
Lamiae Grimaldi-Bensouda, Jean-Yves Le Heuzey, Jean Ferrieres, Didier Leys, Jean-Marc Davy, Mikel Martinez, Olivia Dialla, Didier Smadja, Norbert Nighoghossian, Jacques Benichou, Clementine Nordon, Emmanuel Touze, Lucien Abenhaim
Summary: Individual direct oral anticoagulants show better efficacy compared to vitamin K antagonists in primary stroke prevention in patients with atrial fibrillation, regardless of the presence of permanent AF.
Article
Cardiac & Cardiovascular Systems
Johan Lyth, Emma Svennberg, Lars Bernfort, Mattias Aronsson, Viveka Frykman, Faris Al-Khalili, Leif Friberg, Marten Rosenqvist, Johan Engdahl, Lars-Ake Levin
Summary: This study aimed to evaluate the cost-effectiveness of population-based screening for atrial fibrillation (AF) using clinical outcomes. The analysis showed that the screening intervention group had higher gained life years and gained quality-adjusted life years at a lower cost.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Siddharth M. Patel, Michael G. Palazzolo, Sabina A. Murphy, Elliot M. Antman, Eugene Braunwald, Hans Joachim Lanz, Gregory Y. H. Lip, Robert P. Giugliano, Christian T. Ruff
Summary: ABC pathway-concordant care is associated with reductions in multiple cardiovascular endpoints and all-cause mortality in patients with atrial fibrillation, suggesting potential for improving clinical outcomes.
Article
Medicine, General & Internal
Urs Fischer, Masatoshi Koga, Daniel Strbian, Mattia Branca, Stefanie Abend, Sven Trelle, Maurizio Paciaroni, Goetz Thomalla, Patrik Michel, Krassen Nedeltchev, Leo H. Bonati, George Ntaios, Thomas Gattringer, Else-Charlotte Sandset, Peter Kelly, Robin Lemmens, P. N. Sylaja, Diana Aguiar de Sousa, Natan M. Bornstein, Zuzana Gdovinova, Takeshi Yoshimoto, Marjaana Tiainen, Helen Thomas, Manju Krishnan, Gek C. Shim, Christoph Gumbinger, Jochen Vehoff, Liqun Zhang, Kosuke Matsuzono, Espen Kristoffersen, Philippe Desfontaines, Peter Vanacker, Angelika Alonso, Yusuke Yakushiji, Caterina Kulyk, Dimitri Hemelsoet, Sven Poli, Ana Paiva Nunes, Nicoletta Caracciolo, Peter Slade, Jelle Demeestere, Alexander Salerno, Markus Kneihsl, Timo Kahles, Daria Giudici, Kanta Tanaka, Silja Raty, Rea Hidalgo, David J. Werring, Martina Goldlin, Marcel Arnold, Cecilia Ferrari, Seraina Beyeler, Christian Fung, Bruno J. Weder, Turgut Tatlisumak, Sabine Fenzl, Beata Rezny-Kasprzak, Arsany Hakim, Georgia Salanti, Claudio Bassetti, Jan Gralla, David J. Seiffge, Thomas Horvath, Jesse Dawson
Summary: This study aimed to compare the effect of early initiation versus later initiation of direct oral anticoagulants (DOACs) on acute ischemic stroke in patients with atrial fibrillation. The results showed that there was no significant difference in the incidence of recurrent ischemic stroke, systemic embolism, major extracranial bleeding, symptomatic intracranial hemorrhage, or vascular death within 30 days between early and later use of DOACs.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Yo-Han Jung, Sang-Won Han, Joong-Hyun Park
Summary: This study aimed to investigate the impact of prior antithrombotic use on blood viscosity in patients with cardioembolic stroke. The results showed that patients who had previously used antiplatelets and anticoagulants had significantly decreased systolic and diastolic blood viscosity. Therefore, prior antithrombotic use may be a useful hemorheological parameter in patients with cardioembolic stroke.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Woldesellassie M. Bezabhe, Luke R. Bereznicki, Jan Radford, Barbara C. Wimmer, Mohammed S. Salahudeen, Edward Garrahy, Ivan Bindoff, Gregory M. Peterson
Summary: This study compared the incidence of dementia between users and nonusers of oral anticoagulants in patients with atrial fibrillation. The results showed that patients using direct-acting oral anticoagulants had a lower incidence of dementia compared to those using warfarin or no anticoagulant treatment.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Clinical Neurology
So-Ryoung Lee, Eue-Keun Choi, Jin-Hyung Jung, Sang-Hyun Park, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip
Summary: The study aimed to evaluate the association between body mass index (BMI) and clinical outcomes in Asian patients with atrial fibrillation receiving oral anticoagulants. Results showed that higher BMI was associated with lower risks of ischemic stroke, major bleeding, and better survival, while underweight patients had a higher risk of all-cause death. Optimal BMI for atrial fibrillation patients in Asia should be defined and managed according to an integrated care pathway.
Article
Medicine, General & Internal
Hasan Ashraf, Pradyumna Agasthi, Anusha Shanbhag, Ramila A. Mehta, Pattara Rattanawong, Mohamed Allam, Sai Harika Pujari, Farouk Mookadam, William K. Freeman, Komandoor Srivathsan, Dan Sorajja, Win-Kuang Shen, Peter A. Noseworthy, Eric H. Yang, Hicham Z. El Masry, Xiaoxi Yao, Siva K. Mulpuru, Nirat Beohar, David R. Holmes, Reza Arsanjani
Summary: This study found that inappropriate underdosing of DOACs in patients with atrial fibrillation did not decrease the risk of bleeding, systemic embolization, or all-cause mortality. In particular, inappropriate underdosing of apixaban was associated with increased all-cause mortality.
AMERICAN JOURNAL OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Priit Pauklin, Toomas Marandi, Mart Kals, Tiia Ainla, Katrin Martinson, Jaan Eha, Priit Kampus
Summary: This study examined the lifeday coverage (LDC) of oral anticoagulation (OAC) prescriptions and its impact on one-year mortality rates in atrial fibrillation (AF) patients aged ≥65 in Estonia. The findings indicate that OACs are underused and highlight the need for improved education and awareness among both healthcare professionals and patients.
BMC CARDIOVASCULAR DISORDERS
(2023)
Editorial Material
Medicine, General & Internal
[Anonymous]
Summary: This interactive feature discusses screening for atrial fibrillation in asymptomatic older adults through a case vignette and two essays that present arguments for and against screening.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Economics
Gemma E. Shields, Katherine D. Rogers, Alys Young, Sofia Dedotsi, Linda M. Davies
APPLIED HEALTH ECONOMICS AND HEALTH POLICY
(2020)
Article
Health Care Sciences & Services
Ash Bullement, Tanja Podkonjak, Mark J. Robinson, Eugene Benson, Ross Selby, Anthony J. Hatswell, Gemma E. Shields
INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE
(2020)
Article
Economics
Holly Cranmer, Gemma E. Shields, Ash Bullement
JOURNAL OF MEDICAL ECONOMICS
(2020)
Article
Medicine, General & Internal
Gemma E. Shields, Adrian Wells, Patrick Doherty, David Reeves, Lora Capobianco, Anthony Heagerty, Deborah Buck, Linda M. Davies
Editorial Material
Medicine, General & Internal
Gemma E. Shields, Jamie Elvidge
SYSTEMATIC REVIEWS
(2020)
Article
Economics
Maria Veronica Dorgali, Alberto Longo, Caroline Vass, Gemma Shields, Roger Harrison, Riccardo Scarpa, Marco Boeri
Summary: Research has shown that the risk of antimicrobial resistance is relevant and important to the general public. The high willingness to pay for containing antimicrobial resistance suggests that large investments in policies or interventions are justified.
Article
Cardiac & Cardiovascular Systems
Gemma Elizabeth Shields, Stuart Wright, Adrian Wells, Patrick Doherty, Lora Capobianco, Linda Mary Davies
Summary: This pilot study using a discrete choice experiment (DCE) investigated preferences for delivery attributes of a psychological therapy intervention in CR patients with symptoms of anxiety and/or depression. The study found that sampled participants tended to prefer home-based psychological therapy in CR and wanted to receive information before initiating therapy. Limited statistically significant results were identified, indicating the need for further research.
Article
Economics
Gemma E. Shields, Becky Pennington, Ash Bullement, Stuart Wright, Jamie Elvidge
Summary: The impact of time on historical economic evaluations is significant. Researchers need to consider whether time would affect the results of their studies. Ignoring the impact of time may lead to the use of outdated evidence.
Article
Economics
Gemma E. Shields, Mark Wilberforce, Paul Clarkson, Tracey Farragher, Arpana Verma, Linda M. Davies
Summary: The use of population averages in cost-effectiveness analysis may hide important differences across subgroups. Many challenges may limit the robust inclusion of subgroup analysis in cost-effectiveness analysis, including difficulties with prespecifying and justifying subgroup analysis, identifying implementable subgroups, resource and data requirements, and statistical and ethical concerns. Greater transparency of subgroup reporting is recommended to address these challenges in future research.
Article
Medicine, General & Internal
Gemma E. Shields, Adrian Wells, Stuart Wright, Caroline M. Vass, Patrick Joseph Doherty, Lora Capobianco, Linda M. Davies
Summary: This study investigated preferences for attributes of a psychological therapy intervention in cardiac rehabilitation. The results showed a preference for psychological therapy, particularly individual therapy provided by a specialized professional with lower cost. Participants also preferred to receive information prior to starting therapy. The results for the location attribute were inconsistent and difficult to interpret.
Review
Cardiac & Cardiovascular Systems
Gemma E. Shields, Aleix Rowlandson, Garima Dalal, Stuart Nickerson, Holly Cranmer, Lora Capobianco, Patrick Doherty
Summary: This review found that home-based cardiac rehabilitation (CR) interventions are cost-effective compared to centre-based options. However, the evidence base is limited in size and heterogeneous in methods, and there are several limitations that need to be addressed in future research.
Review
Health Care Sciences & Services
Ash Bullement, Matthew D. Stevenson, Gianluca Baio, Gemma E. Shields, Nicholas R. Latimer
Summary: This review aimed to identify, describe, and categorize established methods to incorporate external evidence into survival extrapolation for health technology assessment (HTA). Across 18 methods identified from 22 studies, common themes included the use of informative prior(s), piecewise approaches, and general population adjustment. Most methods were applied in cancer populations. Further research is needed to assess the differences between these methods.
MEDICAL DECISION MAKING
(2023)
Article
Economics
Holly L. Cranmer, Gemma E. Shields, Ash Bullement
Summary: The study compares two different model structures to analyze the impact of adjusting treatment outcomes on model results for patients with multiple myeloma.
APPLIED HEALTH ECONOMICS AND HEALTH POLICY
(2023)
Article
Medicine, Research & Experimental
Adrian Wells, Karin Carter, Mark Hann, Gemma Shields, Paul Wallis, Beth Cooper, Lora Capobianco
Summary: This study aims to evaluate the acceptability and feasibility of group Metacognitive therapy (MCT) for children and young people with common mental health problems. The therapy may improve access to treatment, reduce waiting times, and improve outcomes. The results of this study will provide important information and data for future research in this area.
PILOT AND FEASIBILITY STUDIES
(2022)
Article
Health Care Sciences & Services
Gemma E. Shields, Lindsey Brown, Adrian Wells, Lora Capobianco, Caroline Vass
Summary: Publications rarely discuss PPI activities in discrete choice experiments of healthcare interventions. This paper presents examples and a detailed case study showcasing the benefits of incorporating PPI across the preference research stages, despite challenges such as time, cost, and expectations. Further research comparing methods related to PPI in preference research would strengthen the literature.
PATIENT-PATIENT CENTERED OUTCOMES RESEARCH
(2021)