Systematic Review Now Available

Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update
(Systematic Review, released on October 30, 2018)

This report updates a previous review on patients with atrial fibrillation/atrial flutter (AF) to determine the best assessment tools for predicting risk of stroke and bleeding, as well as the best treatment options to prevent stroke. Current treatments include new antithrombotic strategies, devices, and oral anticoagulants (oral direct thrombin inhibitors, factor Xa inhibitors).

Selected Key Messages:

CHADS₂, CHA₂DS₂-VASc, and ABC risk scores have the best evidence to support prediction of stroke events. HAS-BLED has the best evidence to support prediction of bleeding risk.
Direct oral anticoagulants (DOAC) are as safe and effective as warfarin for treating patients with atrial fibrillation to prevent stroke.
DOACs dabigatran and apixaban were superior while rivaroxaban and edoxaban were similar to warfarin in the prevention of stroke or systemic embolism
Apixaban and edoxaban were superior to warfarin, and rivaroxaban and dabigatran were similar to warfarin in the risk of major bleeding.
Further RCTs directly comparing oral anticoagulants, including thrombin inhibitors and individual Xa inhibitors, are needed.

For more see: https://effectivehealthcare.ahrq.gov/topics/stroke-afib-update/research-2018

Methods Research Reports Now Available

The following reports are from AHRQ's Health Systems Partnership Pilot Project series. These reports describe the efforts of Evidence-based Practice Centers (EPCs) to work with health care decisionmakers and facilitate the use of information from AHRQ EPC evidence reports.

Linking Evidence Reviews to Organizational Guideline Planning: A Pilot Test of an Interactive, Web-Based Presentation and Discussion of Evidence
(Methods Report, released on October 18, 2018)

This project pilot-tested the effectiveness of a cyberseminar (an interactive, web-based presentation and discussion of evidence) in integrating systematic review findings into organization-specific clinical guidelines within a large, integrated health system.

Disseminating Findings From EPC Reports: Pilot Project of Three Products(Methods Report, released on October 15, 2018)

The purpose of this project is to conduct a pilot study of three dissemination products for an evidence report targeting decision makers in a health system.

Opportunity to Comment on Draft Report

We encourage the public to participate in the development of our research projects. Comments can be submitted for:

Long-term Drug Therapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review
Available for comment until November 27, 2018

Opportunity to Submit Scientific Information

The Effective Health Care (EHC) Program is interested in receiving supplemental evidence and data (SEADs) for systematic reviews that are relevant to the questions in our evidence reports. To ensure that it has full access to relevant research, whether or not it is published, the EHC Program is interested in receiving SEADs containing detailed study-specific information. Opportunities to submit scientific information are available for:

Interventions for the Treatment of Substance Use Disorders in Adolescents
Available for submissions until November 26, 2018

Pharmacologic Management of Acute Pain by EMS in the Prehospital Setting
Available for submissions until November 28, 2018

About us: AHRQ’s Effective Health Care Program is committed to providing the best available evidence on the outcomes, benefits and harms, and appropriateness of drugs, devices, and health care services and by helping health care professionals, patients, policymakers, and health care systems make informed health care decisions. The program partners with research centers, academic institutions, health professional societies, consumer organizations, and other stakeholders to conduct research, evidence synthesis, evidence translation, dissemination, and implementation of research findings.

To learn more: https://www.effectivehealthcare.ahrq.gov