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Clinical prediction guide
A prediction rule identified patients with atrial fibrillation at low risk of stroke while taking aspirin

https://doi.org/10.1136/ebm.9.1.29

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    van Walraven C, Hart RG, Wells GA, et al. A clinical prediction rule to identify patients with atrial fibrillation and a low risk for stroke while taking aspirin. Arch Intern Med 2003;163:936–43.
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 Q What is the accuracy of an age independent clinical prediction rule for identifying patients with non-valvular atrial fibrillation (AF) who are at low risk of all cause stroke or transient ischaemic attack (TIA) while taking aspirin?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory ★★★★★★☆ Geriatrics ★★★★★★☆ Cardiology ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    analysis of data from 6 randomised controlled trials (RCTs) to derive and validate a clinical prediction rule.

    Embedded ImageSetting:

    US, Canada, Denmark, and the Netherlands.

    Embedded ImagePatients:

    2501 patients (mean age 70 y, 67% men, 93% white) with non-valvular AF who were participating in 1 of 6 RCTs. All patients had had no stroke or TIA for at least 6–24 months before entering in the trials and received aspirin at dosages between 75–325 mg/day. In most studies, patients were excluded if they had clinical indications for or contraindications to oral anticoagulation or aspirin therapy, or if they had a recent acute coronary syndrome or cardiac revascularisation. Patients were randomly …

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    Footnotes

    • Abstract and commentary also appear in ACP Journal Club.

    • For correspondence: Dr C van Walraven, Ottawa Health Research Institute, Ottawa, Ontario, Canada. carlvohri.ca

    • Source of funding: no external funding.