For more detailed information about the cookies we use, see our Cookies page.
Essential Cookies enable core functionality such as security, network management, and accessibility. These cookies are necessary for the performance of the service and may not be removed.
Non-Essential Cookies are preference, marketing, and functional cookies that help the application perform to its full extent, advertising related to the IdeaScale marketing website, and ensure the application functions properly. Preferences cookies personalize your experience while accessing IdeaScale by remembering your preferences, such as preferred language and region of origin. Analytics cookies collect anonymized information about how you use the IdeaScale services, such as the IdeaScale pages you visit most frequently and the error messages you encounter. These cookies only analyze your movement within IdeaScale and are used to improve the functioning of IdeaScale services. Marketing cookies advertise IdeaScale services to you elsewhere on the Internet. These cookies enable the delivery of interest-based ads that may be relevant to you as a result of your activities on IdeaScale and provide IdeaScale with information (such as where you saw the ad) to help analyze the impact of its advertising campaigns. IdeaScale also includes links to social networks and third-party sites (for example, Facebook and LinkedIn), which may then use information about your visit to target advertising to you on their websites.
Improving Tools for Anticoagulation Decision-Making
Is this idea a Compelling Question (CQ) or Critical Challenge (CC)?
Critical Challenge (CC)
Details on the impact of addressing this CQ or CC
AFib increases stroke risk by five-fold and doubles the risk that a stroke will result in permanent disability. While oral anticoagulation (OAC) is highly effective at reducing stroke risk, elderly patients are often under-anticoagulated. This is in part due to an under-appreciation of the stroke risk associated with AFib and the tendency of some health care professionals to prioritize perceived bleeding risk over stroke prophylaxis. Because current bleeding risk assessment tools are imperfect and largely unable to predict patients who are likely to have bleeding complications, they are often not utilized—or if used, do not truly predict which patients are at risk of a bleed. An improved bleeding risk tool is critical to improved risk assessment in the elderly. That bleeding risk tool should then be combined with the stroke risk tool for single risk stratification to streamline anticoagulation decision-making.
Feasibility and challenges of addressing this CQ or CC
Developing effective integrated risk assessment tools is feasible only if there is consensus on the validity of the clinical information being provided. The approach to this critical challenge is two-fold. First, needed research that improves the reliability of bleeding risk assessment in the elderly should be pursued. Second, stroke and bleeding risk tools should be combined into a single risk stratification tool. This will require significant investment and focus, but the resulting bleeding risk assessment combined with the accepted CHA2DS2-VASc score, would significantly impact the 40 - 60% of patients who are currently not on an anticoagulant and are at increased risk of stroke and death.
Name of idea submitter and other team members who worked on this idea
AFib Optimal Treatment Task Force