Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores

Background: Clinical risk scores, CHADS(2) and CHA(2)DS(2)-VASc scores, are the established tools for assessing stroke risk in patients with atrial fibrillation (AF). Aim: The aim of this study is to assess concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc sc...

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Autores: Esteve-Pastor, MA, Marin, F, Bertomeu-Martinez, V, Roldan-Rabadan, I, Cequier-Fillat, A, Badimon, L, Muniz-Garcia, J, Valdes, M, Anguita-Sanchez, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p7371
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=7371
http://hdl.handle.net/2183/21961
Access Level:acceso abierto
Palabra clave:atrial fibrillation
stroke risk score
oral anticoagulation
antithrombotic treatment
CHA(2)DS(2)-VASc score
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spelling Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scoresEsteve-Pastor, MAMarin, FBertomeu-Martinez, VRoldan-Rabadan, ICequier-Fillat, ABadimon, LMuniz-Garcia, JValdes, MAnguita-Sanchez, Matrial fibrillationstroke risk scoreoral anticoagulationantithrombotic treatmentCHA(2)DS(2)-VASc scoreBackground: Clinical risk scores, CHADS(2) and CHA(2)DS(2)-VASc scores, are the established tools for assessing stroke risk in patients with atrial fibrillation (AF). Aim: The aim of this study is to assess concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores, as well as to analyse the patient categories using CHADS(2) and the potential improvement on stroke risk stratification with CHA(2)DS(2)-VASc score. Methods: We linked data from Atrial Fibrillation Spanish registry FANTASIIA. Between June 2013 and March 2014, 1318 consecutive outpatients were recruited. We explore the concordance between manual scoring and computer-based calculation. We compare the distribution of embolic risk of patients using both CHADS(2) and CHA(2)DS(2)-VASc scores Results: The mean age was 73.8 +/- 9.4 years, and 758 (57.5%) were male. For CHADS(2) score, concordance between manual scoring and computer-based calculation was 92.5%, whereas for CHA(2)DS(2)-VASc score was 96.4%. In CHADS(2) score, 6.37% of patients with AF changed indication on antithrombotic therapy (3.49% of patients with no treatment changed to need antithrombotic treatment and 2.88% of patients otherwise). Using CHA(2)DS(2)-VASc score, only 0.45% of patients with AF needed to change in the recommendation of antithrombotic therapy. Conclusion: We have found a strong concordance between manual and computer-based score calculation of both CHADS(2) and CHA(2)DS(2)-VASc risk scores with minimal changes in anticoagulation recommendations. The use of CHA(2)DS(2)-VASc score significantly improves classification of AF patients at low and intermediate risk of stroke into higher grade of thromboembolic score. Moreover, CHA(2)DS(2)-VASc score could identify 'truly low risk' patients compared with CHADS(2) score.WILEY2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=7371http://hdl.handle.net/2183/21961INTERNAL MEDICINE JOURNALISSN: 14440903ISSNe: 14455994reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p73712026-06-14T12:41:47Z
dc.title.none.fl_str_mv Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
title Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
spellingShingle Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
Esteve-Pastor, MA
atrial fibrillation
stroke risk score
oral anticoagulation
antithrombotic treatment
CHA(2)DS(2)-VASc score
title_short Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
title_full Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
title_fullStr Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
title_full_unstemmed Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
title_sort Do physicians correctly calculate thromboembolic risk scores? A comparison of concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores
dc.creator.none.fl_str_mv Esteve-Pastor, MA
Marin, F
Bertomeu-Martinez, V
Roldan-Rabadan, I
Cequier-Fillat, A
Badimon, L
Muniz-Garcia, J
Valdes, M
Anguita-Sanchez, M
author Esteve-Pastor, MA
author_facet Esteve-Pastor, MA
Marin, F
Bertomeu-Martinez, V
Roldan-Rabadan, I
Cequier-Fillat, A
Badimon, L
Muniz-Garcia, J
Valdes, M
Anguita-Sanchez, M
author_role author
author2 Marin, F
Bertomeu-Martinez, V
Roldan-Rabadan, I
Cequier-Fillat, A
Badimon, L
Muniz-Garcia, J
Valdes, M
Anguita-Sanchez, M
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv atrial fibrillation
stroke risk score
oral anticoagulation
antithrombotic treatment
CHA(2)DS(2)-VASc score
topic atrial fibrillation
stroke risk score
oral anticoagulation
antithrombotic treatment
CHA(2)DS(2)-VASc score
description Background: Clinical risk scores, CHADS(2) and CHA(2)DS(2)-VASc scores, are the established tools for assessing stroke risk in patients with atrial fibrillation (AF). Aim: The aim of this study is to assess concordance between manual and computer-based calculation of CHADS(2) and CHA(2)DS(2)-VASc scores, as well as to analyse the patient categories using CHADS(2) and the potential improvement on stroke risk stratification with CHA(2)DS(2)-VASc score. Methods: We linked data from Atrial Fibrillation Spanish registry FANTASIIA. Between June 2013 and March 2014, 1318 consecutive outpatients were recruited. We explore the concordance between manual scoring and computer-based calculation. We compare the distribution of embolic risk of patients using both CHADS(2) and CHA(2)DS(2)-VASc scores Results: The mean age was 73.8 +/- 9.4 years, and 758 (57.5%) were male. For CHADS(2) score, concordance between manual scoring and computer-based calculation was 92.5%, whereas for CHA(2)DS(2)-VASc score was 96.4%. In CHADS(2) score, 6.37% of patients with AF changed indication on antithrombotic therapy (3.49% of patients with no treatment changed to need antithrombotic treatment and 2.88% of patients otherwise). Using CHA(2)DS(2)-VASc score, only 0.45% of patients with AF needed to change in the recommendation of antithrombotic therapy. Conclusion: We have found a strong concordance between manual and computer-based score calculation of both CHADS(2) and CHA(2)DS(2)-VASc risk scores with minimal changes in anticoagulation recommendations. The use of CHA(2)DS(2)-VASc score significantly improves classification of AF patients at low and intermediate risk of stroke into higher grade of thromboembolic score. Moreover, CHA(2)DS(2)-VASc score could identify 'truly low risk' patients compared with CHADS(2) score.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=7371
http://hdl.handle.net/2183/21961
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=7371
http://hdl.handle.net/2183/21961
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv INTERNAL MEDICINE JOURNAL
ISSN: 14440903
ISSNe: 14455994
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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