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Sanders GD, Lowenstern A, Borre E, et al. Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Oct. (Comparative Effectiveness Reviews, No. 214.)
Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update [Internet].
Show detailsPubMed® Search Strategy (February 14, 2018)
KQ 1 & KQ 2 In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic and patient outcome efficacy) of available clinical and imaging tools and associated risk factors for predicting thromboembolic risk? In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of clinical tools and associated risk factos for predicting bleeding events?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR “Atrial Flutter”[Mesh] OR “atrial flutter”[tiab] |
| #2 | “Cerebrovascular Disorders”[Majr:NoExp] OR “Stroke”[Mesh] OR “Thromboembolism”[Mesh] OR “Hemorrhage”[Mesh:NoExp] OR “Intracranial Hemorrhages”[Mesh] OR “Brain Ischemia”[Mesh] OR “Prothrombin Time”[Mesh] OR stroke[tiab] OR strokes[tiab] OR thromboembolism[tiab] OR thromboembolisms[tiab] OR thromboembolic[tiab] OR thromboses[tiab] OR hemorrhage[tiab] OR hemorrhages[tiab] OR hemorrhaging[tiab] OR hemorrhagic[tiab] OR haemorrhage[tiab] OR haemorrhages[tiab] OR haemorrhaging[tiab] OR haemorrhagic[tiab] OR ((“bleeding”[tiab] OR bleed[tiab] OR bleeds[tiab]) AND (major[tiab] OR risk[tiab] OR event[tiab])) OR ((Systemic[tiab] OR paradoxical[tiab] OR crossed[tiab]) AND (embolism[tiab] OR embolisms[tiab])) OR ((brain[tiab] OR cerebral[tiab] OR brainstem[tiab] OR “brain stem”[tiab]) AND (ischemia[tiab] OR ischaemia[tiab] OR ischemias[tiab] OR ischaemias[tiab] OR infarction[tiab] OR infarctions[tiab])) OR (transient[tiab] AND (ischemic[tiab] OR ischaemic[tiab] OR ischaemia[tiab] OR ischemia[tiab]) AND (attack[tiab] OR attacks[tiab])) OR TIA[tiab] OR TIAs[tiab] OR “cerebrovascular accident”[tiab] OR “cerebrovascular accidents”[tiab] OR CVA[tiab] OR CVAs[tiab] OR “brain vascular accident”[tiab] OR “brain vascular accidents”[tiab] |
| #3 | “Risk”[Mesh] OR risk[tiab] OR risks[tiab] OR “Predictive Value of Tests”[Mesh] OR predict[tiab] OR predicts[tiab] OR predicting[tiab] OR predictor[tiab] OR predictors[tiab] OR predictive[tiab] |
| #4 | #1 AND #2 AND #3 |
| #5 | #4 NOT (Editorial[ptyp] OR Letter[ptyp] OR Case Reports[ptyp] OR Comment[ptyp]) |
| #6 | #5 NOT (“Animals”[MeSH Terms] NOT “Humans”[MeSH Terms]) |
| #7 | #6 NOT ((“Adolescent”[Mesh] OR “Child”[Mesh] OR “Infant”[Mesh]) NOT “Adult”[Mesh]) |
| #8 | “Randomized Controlled Trial”[Publication Type] OR “Controlled Clinical Trial”[Publication Type] OR randomized[tiab] OR randomised[tiab] OR randomization[tiab] OR randomisation[tiab] OR placebo[tiab] OR randomly[tiab] OR trial[tiab] OR groups[tiab] OR “Clinical Trial”[Publication Type] OR “clinical trial”[tiab] OR “clinical trials”[tiab] OR “Evaluation Studies”[Publication Type] OR “Evaluation Studies as Topic”[MeSH Terms] OR “evaluation study”[tiab] OR “evaluation studies”[tiab] OR “intervention study”[tiab] OR “intervention studies”[tiab] OR “Case-control Studies”[MeSH Terms] OR “case-control”[tiab] OR “Cohort Studies”[Mesh Terms] OR cohort[tiab] OR “Longitudinal Studies”[MeSH Terms] OR longitudinal[tiab] OR longitudinally[tiab] OR “Prospective Studies”[Mesh Terms] OR “prospective”[tiab] OR prospectively[tiab] OR “Retrospective Studies”[MeSH Terms] OR “retrospective”[tiab] OR “Follow-Up Studies”[Mesh Terms] OR “follow up”[tiab] OR “Comparative Study”[Publication Type] OR “comparative study”[tiab] OR systematic[subset] OR “systematic review”[tiab] OR “meta-analysis”[Publication Type] OR “meta-analysis as topic”[MeSH Terms] OR “meta-analysis”[tiab] OR “meta-analyses”[tiab] OR “meta synthesis”[tiab] OR “meta syntheses”[tiab] OR “Multicenter Study”[Publication Type] OR “Multicenter Study”[tiab] OR multicentre[tiab] OR “Registries”[Mesh Terms] OR registry[tiab] OR registries[tiab] OR “Sensitivity and Specificity”[Mesh] OR Sensitivity[tiab] OR specificity[tiab] OR valid[tiab] OR validity[tiab] OR validation[tiab] OR “validation studies”[publication type] |
| #9 | #7 AND #8 |
| #10 | #9 AND (“2011/08/01”[Date - Publication]: “3000”[Date - Publication]) |
KQ 3 What are the comparative safety and effectiveness of specific anticoagulation therapies, antiplatelet therapies, and procedural interventions for preventing thromboembolic events:
- a)
In patients with nonvalvular atrial fibrillation?
- b)
In specific subpopulations of patients with nonvalvular atrial fibrillation?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR “Atrial Flutter”[Mesh] OR “atrial flutter”[tiab] |
| #2 | “Cerebrovascular Disorders”[Majr:NoExp] OR “Stroke”[Mesh] OR “Thromboembolism”[Mesh] OR “Hemorrhage”[Mesh:NoExp] OR “Intracranial Hemorrhages”[Mesh] OR “Brain Ischemia”[Mesh] OR “Prothrombin Time”[Mesh] OR stroke[tiab] OR strokes[tiab] OR thromboembolism[tiab] OR thromboembolisms[tiab] OR thromboembolic[tiab] OR thromboses[tiab] OR hemorrhage[tiab] OR hemorrhages[tiab] OR hemorrhaging[tiab] OR hemorrhagic[tiab] OR haemorrhage[tiab] OR haemorrhages[tiab] OR haemorrhaging[tiab] OR haemorrhagic[tiab] OR ((“bleeding”[tiab] OR bleed[tiab] OR bleeds[tiab]) AND (major[tiab] OR risk[tiab] OR event[tiab])) OR ((Systemic[tiab] OR paradoxical[tiab] OR crossed[tiab]) AND (embolism[tiab] OR embolisms[tiab])) OR ((brain[tiab] OR cerebral[tiab] OR brainstem[tiab] OR “brain stem”[tiab]) AND (ischemia[tiab] OR ischaemia[tiab] OR ischemias[tiab] OR ischaemias[tiab] OR infarction[tiab] OR infarctions[tiab])) OR (transient[tiab] AND (ischemic[tiab] OR ischaemic[tiab] OR ischaemia[tiab] OR ischemia[tiab]) AND (attack[tiab] OR attacks[tiab])) OR TIA[tiab] OR TIAs[tiab] OR “cerebrovascular accident”[tiab] OR “cerebrovascular accidents”[tiab] OR CVA[tiab] OR CVAs[tiab] OR “brain vascular accident”[tiab] OR “brain vascular accidents”[tiab] |
| #3 | “Risk”[Mesh] OR risk[tiab] OR risks[tiab] OR “Safety”[Mesh] OR safety[tiab] OR safe[tiab] OR “Incidence”[Mesh] OR efficacy[tiab] OR efficacious[tiab] OR “prevention and control”[Subheading] OR prevent[tiab] OR prevents[tiab] OR preventing[tiab] OR prevention[tiab] OR “Treatment Outcome”[Mesh] OR “adverse effects”[Subheading] OR side effect*[tiab] OR (adverse[tiab] AND (interaction*[tiab] or response*[tiab] or effect*[tiab] or event*[tiab] or reaction*[tiab] or outcome*[tiab])) OR (unintended[tiab] AND (interaction*[tiab] or response*[tiab] or effect*[tiab] or event*[tiab] or reaction*[tiab] or outcome*[tiab])) OR (unintentional[tiab] AND (interaction*[tiab] or response*[tiab] or effect*[tiab] or event*[tiab] or reaction*[tiab] or outcome*[tiab])) OR (unwanted[tiab] AND (interaction*[tiab] or response*[tiab] or effect*[tiab] or event*[tiab] or reaction*[tiab] or outcome*[tiab])) OR (unexpected AND (interaction*[tiab] or response*[tiab] or effect*[tiab] or event*[tiab] or reaction*[tiab] or outcome*[tiab])) OR (undesirable AND (interaction*[tiab] or response*[tiab] or effect*[tiab] or event*[tiab] or reaction*[tiab] or outcome*[tiab])) OR “drug safety”[tiab] OR “drug toxicity”[tiab] OR tolerability[tiab] OR harm[tiab] OR harms[tiab] OR harmful[tiab] OR “treatment emergent”[tiab] OR complication*[tiab] OR toxicity[tiab] |
| #4 | #1 AND #2 AND #3 |
| #5 | “Anticoagulants”[Mesh] OR “Warfarin”[Mesh] OR “Heparin”[Mesh] OR “Vitamin K/antagonists and inhibitors”[Mesh] OR “Rivaroxaban”[Mesh] OR Antithrombins[Pharmacological Action] OR “Dabigatran”[Mesh] OR “Blood Coagulation Factor Inhibitors”[Mesh] OR “Anticoagulants”[Pharmacological Action] OR “Factor Xa Inhibitors”[Pharmacological Action] OR “apixaban”[Supplementary Concept] OR “edoxaban”[Supplementary Concept] OR warfarin[tiab] OR coumadin[tiab] OR “vitamin k”[tiab] OR enoxaparin[tiab] OR lovenox[tiab] OR rivaroxaban[tiab] OR xarelto[tiab] OR dabigatran[tiab] OR pradaxa[tiab] OR heparin[tiab] OR apixaban[tiab] OR eliquis[tiab] OR edoxaban[tiab] OR lixiana[tiab] OR anticoagulant[tiab] OR anticoagulants[tiab] OR anticoagulation[tiab] OR “thrombin inhibitor”[tiab] OR “thrombin inhibitors”[tiab] OR antithrombin[tiab] OR antithrombins[tiab] OR antithrombotic[tiab] OR “factor Xa inhibitor”[tiab] OR “factor Xa inhibitors”[tiab] OR “Blood clotting inhibitor”[tiab] OR “blood clotting inhibitors”[tiab] |
| #6 | #4 AND #5 |
| #7 | “Platelet Aggregation Inhibitors”[Mesh] OR “Aspirin”[Mesh] OR “Dipyridamole”[Mesh] OR “Platelet Aggregation Inhibitors”[Pharmacological Action] OR clopidogrel[Supplementary Concept] OR clopidogrel[tiab] OR plavix[tiab] OR aspirin[tiab] OR dipyridamole[tiab] OR aggrenox[tiab] OR persantine[tiab] OR curantil[tiab] OR antiplatelet[tiab] OR anti-platelet[tiab] OR antiplatelets[tiab] OR anti-platelets[tiab] OR “platelet aggregation inhibitors”[tiab] OR “platelet aggregation inhibitor”[tiab] OR “platelet inhibitors”[tiab] OR “platelet inhibitor”[tiab] OR “platelet antagonists”[tiab] OR “platelet antagonist”[tiab] |
| #8 | #4 AND #7 |
| #9 | “atrial appendage/surgery”[Mesh Terms] OR “Septal Occluder Device”[Mesh] OR “atrial appendage”[tiab] OR “atrial appendages”[tiab] OR “atrium appendage”[tiab] OR “auricular appendage”[tiab] OR “auricular appendages”[tiab] OR LAA[tiab] OR occluder[tiab] OR occluders[tiab] OR occlusion[tiab] OR AMPLATZER[tiab] OR AtriClip[tiab] OR PLAATO[tiab] OR Watchman[tiab] OR (atrial[tiab] AND modification[tiab]) OR lariat[tiab] OR atricure[tiab] |
| #10 | #4 AND #9 |
| #11 | #6 OR #8 OR #10 |
| #12 | #11 NOT (Editorial[ptyp] OR Letter[ptyp] OR Case Reports[ptyp] OR Comment[ptyp]) |
| #13 | #12 NOT (“Animals”[MeSH Terms] NOT “Humans”[MeSH Terms]) |
| #14 | #13 NOT ((“Adolescent”[Mesh] OR “Child”[Mesh] OR “Infant”[Mesh]) NOT “Adult”[Mesh]) |
| #15 | “Randomized Controlled Trial”[Publication Type] OR “Controlled Clinical Trial”[Publication Type] OR randomized[tiab] OR randomised[tiab] OR randomization[tiab] OR randomisation[tiab] OR placebo[tiab] OR randomly[tiab] OR trial[tiab] OR groups[tiab] OR “Clinical Trial”[Publication Type] OR “clinical trial”[tiab] OR “clinical trials”[tiab] OR “Evaluation Studies”[Publication Type] OR “Evaluation Studies as Topic”[MeSH Terms] OR “evaluation study”[tiab] OR “evaluation studies”[tiab] OR “intervention study”[tiab] OR “intervention studies”[tiab] OR “Case-control Studies”[MeSH Terms] OR “case-control”[tiab] OR “Cohort Studies”[Mesh Terms] OR cohort[tiab] OR “Longitudinal Studies”[MeSH Terms] OR longitudinal[tiab] OR longitudinally[tiab] OR “Prospective Studies”[Mesh Terms] OR “prospective”[tiab] OR prospectively[tiab] OR “Retrospective Studies”[MeSH Terms] OR “retrospective”[tiab] OR “Follow-Up Studies”[Mesh Terms] OR “follow up”[tiab] OR “Comparative Study”[Publication Type] OR “comparative study”[tiab] OR systematic[subset] OR “systematic review”[tiab] OR “meta-analysis”[Publication Type] OR “meta-analysis as topic”[MeSH Terms] OR “meta-analysis”[tiab] OR “meta-analyses”[tiab] OR “meta synthesis”[tiab] OR “meta syntheses”[tiab] OR “Multicenter Study”[Publication Type] OR “Multicenter Study”[tiab] OR multicentre[tiab] OR “Registries”[Mesh Terms] OR registry[tiab] OR registries[tiab] OR “Sensitivity and Specificity”[Mesh] OR Sensitivity[tiab] OR specificity[tiab] OR valid[tiab] OR validity[tiab] OR validation[tiab] OR “validation studies”[publication type] |
| #16 | #14 AND #15 |
| #17 | #16 AND (“2011/08/01”[Date - Publication]: “3000”[Date - Publication]) |
PubMed® Search Strategy (August 14, 2012)
KQ 1: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of available clinical and imaging tools for predicting thromboembolic risk?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR (atrial[tiab] AND fibrillation[tiab]) OR afib[tiab] OR “atrial flutter”[MeSH Terms] OR “atrial flutter”[tiab] |
| #2 | chads2[tw] OR chads2-vasc[tw] OR “Magnetic Resonance Imaging”[Mesh] OR MRI[tw] OR “Cardiac Imaging Techniques”[Mesh] OR “Tomography, X-Ray Computed”[Mesh] OR “Echocardiography”[Mesh] OR ((transthoracic[tw] OR transesophageal[tw]) AND echo[tw]) OR TTE[tw] OR TEE[tw] OR CT-scan[tw] |
| #3 | “Stroke”[Mesh] OR stroke[tw] OR thromboembolism[tw] OR “Thromboembolism”[Mesh] OR thromboembolic[tw] OR “brain ischemia”[MeSH Terms] OR (brain[tw] AND ischemia[tw]) OR (brain[tw] AND ischaemia[tw]) OR (transient[tw] AND (ischemic[tw] OR ischaemic[tw] OR ischaemia[tw] OR ischemia[tw]) AND attack[tw]) OR TIA[tw] |
| #4 | #1 AND #2 AND #3 |
| #5 | ((“diagnosis”[Subheading] OR “diagnosis”[tiab] OR “diagnosis”[MeSH Terms]) OR “treatment outcome”[MeSH Terms] OR outcome[tiab] OR outcomes[tiab]) OR (reliability[tw] OR accuracy[tw] OR accurate[tw] OR Sensitivity[tw] OR specificity[tw] OR “Sensitivity and Specificity”[Mesh] OR valid[tw] OR validity[tw] OR validation[tw] OR decision[tw] OR decisions[tw] OR “decision making”[MeSH Terms] OR assessment[tw]) |
| #6 | #5 AND #4 |
| #7 | #6 NOT (animals[mh] NOT humans[mh]), Limits: English, Publication Date from 2000 to present |
KQ 2: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of clinical tools and associated risk factors for predicting bleeding events?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR (atrial[tiab] AND fibrillation[tiab]) OR afib[tiab] OR “atrial flutter”[MeSH Terms] OR “atrial flutter”[tiab] |
| #2 | “Age Factors”[Mesh] OR “Dementia”[Mesh] OR “Accidental Falls”[Mesh] OR “International Normalized Ratio”[Mesh] OR age[tiab] OR dementia[tiab] OR INR[tiab] OR fall[tiab] OR falls[tiab] OR “international normalized ratio”[tiab] OR paroxysmal[tiab] OR persistent[tiab] OR permanent[tiab] OR stratification[tiab] OR classification[tiab] OR schema[tiab] OR has-bled[tiab] OR (cognitive[tw] AND impairment[tw]) OR cognition[tw] OR ((prior[tiab] OR previous[tiab] OR first[tiab]) AND stroke[tiab]) |
| #3 | “Intracranial Hemorrhages”[Mesh] OR “Hemorrhage”[Mesh:noexp] OR hemorrhage[tw] OR hemorrhaging[tw] OR bleeding[tw] OR bleed[tw] OR hemorrhagic[tw] OR haemorrhage[tw] OR haemorrhaging[tw] OR haemorrhagic[tw] |
| #4 | #1 AND #2 AND #3 |
| #5 | ((“diagnosis”[Subheading] OR “diagnosis”[tiab] OR “diagnosis”[MeSH Terms]) OR “treatment outcome”[MeSH Terms] OR outcome[tiab] OR outcomes[tiab]) OR (reliability[tw] OR accuracy[tw] OR accurate[tw] OR Sensitivity[tw] OR specificity[tw] OR “Sensitivity and Specificity”[Mesh] OR valid[tw] OR validity[tw] OR validation[tw] OR decision[tw] OR decisions[tw] OR “decision making”[MeSH Terms] OR assessment[tw]) |
| #6 | #5 AND #4 |
| #7 | #6 NOT (animals[mh] NOT humans[mh]), Limits: English, Publication Date from 2000 to present |
KQ 3: What are the comparative safety and effectiveness of specific anticoagulation therapies, antiplatelet therapies, and procedural interventions for preventing thromboembolic events:
- (a)
In patients with nonvalvular atrial fibrillation?
- (b)
In specific subpopulations of patients with nonvalvular atrial fibrillation?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR (atrial[tiab] AND fibrillation[tiab]) OR afib[tiab] OR “atrial flutter”[MeSH Terms] OR “atrial flutter”[tiab] |
| #2 | “Anticoagulants”[Mesh] OR “Anticoagulants”[Pharmacological Action] OR warfarin[tw] OR “Warfarin”[Mesh] OR coumadin[tw] OR “Vitamin K/antagonists and inhibitors”[Mesh] OR vitamin k[tw] OR “Heparin”[Mesh] OR “Enoxaparin”[Mesh] OR enoxaparin[tw] OR lovenox[tw] OR “rivaroxaban” [Supplementary Concept] OR rivaroxaban[tw] OR xarelto[tw] OR “dabigatran etexilate” [Supplementary Concept] OR dabigatran[tw] OR pradaxa[tw] OR heparin[tw] OR “apixaban” [Supplementary Concept] OR apixaban[tw] OR eliquis[tw] OR “edoxaban” [Supplementary Concept] OR edoxaban[tw] OR lixiana[tw] |
| #3 | “Platelet Aggregation Inhibitors”[Mesh] OR “Platelet Aggregation Inhibitors”[Pharmacological Action] OR “clopidogrel” [Supplementary Concept]OR clopidogrel[tw] OR plavix[tw] OR “Aspirin”[Mesh] OR aspirin[tw] OR “Dipyridamole”[Mesh] OR dipyridamole[tw] OR aggrenox[tw] OR persantine[tw] OR antiplatelet[tw] OR anti-platelet[tw] OR antiplatelets[tw] OR anti-platelets[tw] |
| #4 | Atrial Appendage/surgery[mesh] OR atrial appendage[tw] OR LAA[tw] OR occluder[tw] OR AMPLATZER[tw] OR AtriClip[tw] OR PLAATO[tw] OR Watchman[tw] OR (atrial[tw] AND modification[tw]) OR “atriacure isolator”[tw] |
| #5 | “Stroke”[Mesh] OR stroke[tw] OR thromboembolism[tw] OR “Thromboembolism”[Mesh] OR thromboembolic[tw] OR “brain ischemia”[MeSH Terms] OR (brain[tw] AND ischemia[tw]) OR (brain[tw] AND ischaemia[tw]) OR (transient[tw] AND (ischemic[tw] OR ischaemic[tw] OR ischaemia[tw] OR ischemia[tw]) AND attack[tw]) OR TIA[tw] |
| #6 | #1 AND (#2 OR #3 OR #4) AND #5 |
| #7 | “evaluation studies”[Publication Type] OR “evaluation studies as topic”[MeSH Terms] OR “evaluation study”[tw] OR evaluation studies[tw] OR “intervention studies”[MeSH Terms] OR “intervention study”[tw] OR “intervention studies”[tw] OR “case-control studies”[MeSH Terms] OR “case-control”[tw] OR “cohort studies”[MeSH Terms] OR cohort[tw] OR “longitudinal studies”[MeSH Terms] OR “longitudinal”[tw] OR longitudinally[tw] OR “prospective”[tw] OR prospectively[tw] OR “retrospective studies”[MeSH Terms] OR “retrospective”[tw] OR “follow up”[tw] OR “comparative study”[Publication Type] OR “comparative study”[tw] OR systematic[subset] OR “meta-analysis”[Publication Type] OR “meta-analysis as topic”[MeSH Terms] OR “meta-analysis”[tw] OR “meta-analyses”[tw] OR randomized controlled trial[pt] OR controlled clinical trial[pt] OR randomized[tiab] OR randomised[tiab] OR randomization[tiab] OR randomisation[tiab] OR placebo[tiab] OR “drug therapy”[Subheading] OR randomly[tiab] OR trial[tiab] OR groups[tiab] OR Clinical trial[pt] OR “clinical trial”[tw] OR “clinical trials”[tw] NOT (Editorial[ptyp] OR Letter[ptyp] OR Case Reports[ptyp] OR Comment[ptyp]) |
| #8 | #7 AND #6 |
| #9 | #8 NOT (animals[mh] NOT humans[mh]), Limits: English, Publication Date from 2000 to present |
KQ 4: What are the comparative safety and effectiveness of available strategies for anticoagulation in patients with nonvalvular atrial fibrillation who are undergoing invasive procedures?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR (atrial[tiab] AND fibrillation[tiab]) OR afib[tiab] OR “atrial flutter”[MeSH Terms] OR “atrial flutter”[tiab] |
| #2 | “Anticoagulants”[Mesh] OR “Anticoagulants”[Pharmacological Action] OR warfarin[tw] OR “Warfarin”[Mesh] OR coumadin[tw] OR “Vitamin K/antagonists and inhibitors”[Mesh] OR vitamin k[tw] OR “Heparin”[Mesh] OR “Enoxaparin”[Mesh] OR enoxaparin[tw] OR lovenox[tw] OR “rivaroxaban” [Supplementary Concept] OR rivaroxaban[tw] OR xarelto[tw] OR “dabigatran etexilate” [Supplementary Concept] OR dabigatran[tw] OR pradaxa[tw] OR heparin[tw] OR “apixaban” [Supplementary Concept] OR apixaban[tw] OR eliquis[tw] OR “edoxaban” [Supplementary Concept] OR edoxaban[tw] OR lixiana[tw] |
| #3 | “Surgical Procedures, Operative”[Mesh] OR /surgery[mesh] OR ((surgical[tw] OR invasive[tw]) AND (procedure[tw] OR procedures[tw])) OR “dental care”[MeSH Terms] OR (dental[tw] AND (procedure[tw] OR procedures[tw])) OR surgery[tw] OR procedures[tiab] OR procedure[tiab] |
| #4 | #1 AND #2 AND #3 |
| #5 | “evaluation studies”[Publication Type] OR “evaluation studies as topic”[MeSH Terms] OR “evaluation study”[tw] OR evaluation studies[tw] OR “intervention studies”[MeSH Terms] OR “intervention study”[tw] OR “intervention studies”[tw] OR “case-control studies”[MeSH Terms] OR “case-control”[tw] OR “cohort studies”[MeSH Terms] OR cohort[tw] OR “longitudinal studies”[MeSH Terms] OR “longitudinal”[tw] OR longitudinally[tw] OR “prospective”[tw] OR prospectively[tw] OR “retrospective studies”[MeSH Terms] OR “retrospective”[tw] OR “follow up”[tw] OR “comparative study”[Publication Type] OR “comparative study”[tw] OR systematic[subset] OR “meta-analysis”[Publication Type] OR “meta-analysis as topic”[MeSH Terms] OR “meta-analysis”[tw] OR “meta-analyses”[tw] OR randomized controlled trial[pt] OR controlled clinical trial[pt] OR randomized[tiab] OR randomised[tiab] OR randomization[tiab] OR randomisation[tiab] OR placebo[tiab] OR “drug therapy”[Subheading] OR randomly[tiab] OR trial[tiab] OR groups[tiab] OR Clinical trial[pt] OR “clinical trial”[tw] OR “clinical trials”[tw] NOT (Editorial[ptyp] OR Letter[ptyp] OR Case Reports[ptyp] OR Comment[ptyp]) |
| #6 | #5 AND #4 |
| #7 | #7 NOT (animals[mh] NOT humans[mh]), Limits: English, Publication Date from 2000 to present |
KQ 5: What are the comparative safety and effectiveness of available strategies for switching between warfarin and other novel oral anticoagulants, in patients with nonvalvular atrial fibrillation?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR (atrial[tiab] AND fibrillation[tiab]) OR afib[tiab] OR “atrial flutter”[MeSH Terms] OR “atrial flutter”[tiab] |
| #2 | “warfarin”[MeSH Terms] OR warfarin[tw] OR coumadin[tw] |
| #3 | “antithrombins”[MeSH Terms] OR “antithrombins”[tiab] OR (“direct”[tiab] AND “thrombin”[tiab] AND “inhibitors”[tiab]) OR “direct thrombin inhibitors”[tiab] OR “antithrombins”[Pharmacological Action] |
| #4 | “Anticoagulants”[Mesh] OR “Anticoagulants” [Pharmacological Action] OR anticoagulant[tiab] OR anticoagulants[tiab] |
| #5 | “evaluation studies”[Publication Type] OR “evaluation studies as topic”[MeSH Terms] OR “evaluation study”[tw] OR evaluation studies[tw] OR “intervention studies”[MeSH Terms] OR “intervention study”[tw] OR “intervention studies”[tw] OR “case-control studies”[MeSH Terms] OR “case-control”[tw] OR “cohort studies”[MeSH Terms] OR cohort[tw] OR “longitudinal studies”[MeSH Terms] OR “longitudinal”[tw] OR longitudinally[tw] OR “prospective”[tw] OR prospectively[tw] OR “retrospective studies”[MeSH Terms] OR “retrospective”[tw] OR “follow up”[tw] OR “comparative study”[Publication Type] OR “comparative study”[tw] OR systematic[subset] OR “meta-analysis”[Publication Type] OR “meta-analysis as topic”[MeSH Terms] OR “meta-analysis”[tw] OR “meta-analyses”[tw] OR randomized controlled trial[pt] OR controlled clinical trial[pt] OR randomized[tiab] OR randomised[tiab] OR randomization[tiab] OR randomisation[tiab] OR placebo[tiab] OR “drug therapy”[Subheading] OR randomly[tiab] OR trial[tiab] OR groups[tiab] OR Clinical trial[pt] OR “clinical trial”[tw] OR “clinical trials”[tw] NOT (Editorial[ptyp] OR Letter[ptyp] OR Case Reports[ptyp] OR Comment[ptyp]) |
| #6 | #1 AND #2 AND (#3 OR #4) AND #5 |
| #7 | #6 NOT (animals[mh] NOT humans[mh]), Limits: English, Publication Date from 2000 to present |
KQ 6: What are the comparative safety and effectiveness of available strategies for resuming anticoagulation therapy or performing a procedural intervention as a stroke prevention strategy following a hemorrhagic event (stroke, major bleed, or minor bleed) in patients with nonvalvular atrial fibrillation?
| #1 | “Atrial Fibrillation”[Mesh] OR “atrial fibrillation”[tiab] OR (atrial[tiab] AND fibrillation[tiab]) OR afib[tiab] OR “atrial flutter”[MeSH Terms] OR “atrial flutter”[tiab] |
| #2 | “Anticoagulants”[Mesh] OR “Anticoagulants”[Pharmacological Action] OR warfarin[tw] OR “Warfarin”[Mesh] OR coumadin[tw] OR “Vitamin K/antagonists and inhibitors”[Mesh] OR vitamin k[tw] OR “Heparin”[Mesh] OR “Enoxaparin”[Mesh] OR enoxaparin[tw] OR lovenox[tw] OR “rivaroxaban” [Supplementary Concept] OR rivaroxaban[tw] OR xarelto[tw] OR “dabigatran etexilate” [Supplementary Concept] OR dabigatran[tw] OR pradaxa[tw] OR heparin[tw] OR “apixaban” [Supplementary Concept] OR apixaban[tw] OR eliquis[tw] OR “edoxaban” [Supplementary Concept] OR edoxaban[tw] OR lixiana[tw] |
| #3 | “Intracranial Hemorrhages”[Mesh] OR “Hemorrhage”[Mesh:noexp] OR hemorrhage[tw] OR hemorrhaging[tw] OR bleeding[tw] OR bleed[tw] OR hemorrhagic[tw] OR haemorrhage[tw] OR haemorrhaging[tw] OR haemorrhagic[tw] |
| #4 | Resume[tiab] OR resumed[tiab] OR restart[tiab] OR restarted[tiab] OR restarting[tiab] OR re-initiate[tiab] OR reinitiate[tiab] OR continue[tiab] OR continued[tiab] OR start[tiab] OR “time factors”[MeSH Terms] OR resumption[tiab] OR reinitiating[tiab] OR resuming[tiab] OR continuing[tiab] |
| #5 | #1 AND #2 AND #3 AND #4 |
| #6 | “evaluation studies”[Publication Type] OR “evaluation studies as topic”[MeSH Terms] OR “evaluation study”[tw] OR evaluation studies[tw] OR “intervention studies”[MeSH Terms] OR “intervention study”[tw] OR “intervention studies”[tw] OR “case-control studies”[MeSH Terms] OR “case-control”[tw] OR “cohort studies”[MeSH Terms] OR cohort[tw] OR “longitudinal studies”[MeSH Terms] OR “longitudinal”[tw] OR longitudinally[tw] OR “prospective”[tw] OR prospectively[tw] OR “retrospective studies”[MeSH Terms] OR “retrospective”[tw] OR “follow up”[tw] OR “comparative study”[Publication Type] OR “comparative study”[tw] OR systematic[subset] OR “meta-analysis”[Publication Type] OR “meta-analysis as topic”[MeSH Terms] OR “meta-analysis”[tw] OR “meta-analyses”[tw] OR randomized controlled trial[pt] OR controlled clinical trial[pt] OR randomized[tiab] OR randomised[tiab] OR randomization[tiab] OR randomisation[tiab] OR placebo[tiab] OR “drug therapy”[Subheading] OR randomly[tiab] OR trial[tiab] OR groups[tiab] OR Clinical trial[pt] OR “clinical trial”[tw] OR “clinical trials”[tw] NOT (Editorial[ptyp] OR Letter[ptyp] OR Case Reports[ptyp] OR Comment[ptyp]) |
| #7 | #5 AND #6 |
| #8 | #7 NOT (animals[mh] NOT humans[mh]), Limits: English, Publication Date from 2000 to present |
Embase® Search Strategy (February 14, 2018)
Platform: Embase.com
KQ 1 & KQ 2: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic and patient outcome efficacy) of available clinical and imaging tools and associated risk factors for predictin thromboembolic risk? & In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of clinical tools and associated risk factos for predicting bleeding events?
| #1 | ‘atrial fibrillation’/exp OR ‘heart atrium flutter’/exp OR ‘atrial fibrillation’:ab,ti OR ‘atrial flutter’:ab,ti |
| #2 | ‘cerebrovascular disease’/de OR ‘cerebrovascular accident’/exp OR ‘thromboembolism’/exp OR ‘bleeding’/de OR ‘brain hemorrhage’/exp OR ‘brain ischemia’/exp OR ‘prothrombin time’/exp OR stroke:ab,ti OR strokes:ab,ti OR thromboembolism:ab,ti OR thromboembolisms:ab,ti OR thromboembolic:ab,ti OR thromboses:ab,ti OR hemorrhage:ab,ti OR hemorrhages:ab,ti OR hemorrhaging:ab,ti OR hemorrhagic:ab,ti OR haemorrhage:ab,ti OR haemorrhages:ab,ti OR haemorrhaging:ab,ti OR haemorrhagic:ab,ti OR ((bleeding OR bleed OR bleeds) NEAR/2 (major OR risk OR event)):ab,ti OR ((systemic OR paradoxical OR crossed) NEXT/2 (embolism OR embolisms)):ab,ti OR ((brain OR cerebral OR brainstem OR ‘brain stem’) NEXT/2 (ischemia OR ischaemia OR ischemias OR ischaemias OR infarction OR infarctions)):ab,ti OR (transient NEXT/2 (ischemic OR ischaemic OR ischaemia OR ischemia) NEXT/2 (attack OR attacks)):ab,ti OR tia:ab,ti OR tias:ab,ti OR ‘cerebrovascular accident’:ab,ti OR ‘cerebrovascular accidents’:ab,ti OR cva:ab,ti OR cvas:ab,ti OR ‘brain vascular accident’:ab,ti OR ‘brain vascular accidents’:ab,ti |
| #3 | ‘risk’/exp OR risk:ab,ti OR risks:ab,ti OR ‘prediction and forecasting’/exp OR predict:ab,ti OR predicts:ab,ti OR predicting:ab,ti OR predictor:ab,ti OR predictors:ab,ti OR predictive:ab,ti |
| #4 | #1 AND #2 AND #3 |
| #5 | #4 NOT (‘case report’/exp OR ‘case study’/exp OR ‘a case report’:ti OR ‘: case report’:ti OR ‘editorial’/exp OR ‘letter’/exp OR ‘note’/exp OR [conference abstract]/lim) |
| #6 | #5 AND [humans]/lim |
| #7 | #6 NOT ((‘adolescent’/exp OR ‘child’/exp) NOT ‘adult’/exp) |
| #8 | ‘clinical trial’/exp OR ‘clinical study’/exp OR ‘controlled study’/exp OR randomized:ab,ti OR randomised:ab,ti OR randomization:ab,ti OR randomisation:ab,ti OR randomly:ab,ti OR placebo:ab,ti OR trial:ab,ti OR groups:ab,ti OR ‘crossover procedure’/exp OR ‘double blind procedure’/exp OR ‘single blind procedure’/exp OR crossover*:ab,ti OR (cross NEXT/1 over*):ab,ti OR ‘clinical trial’:ab,ti OR ‘clinical trials’:ab,ti OR ‘clinical study’:ab,ti OR ‘clinical studies’:ab,ti OR ‘evaluation study’/exp OR ‘evaluation study’:ab,ti OR ‘evaluation studies’:ab,ti OR ‘intervention study’:ab,ti OR ‘intervention studies’:ab,ti OR ‘case-control’:ab,ti OR ‘cohort analysis’/exp OR cohort:ab,ti OR longitudinal:ab,ti OR longitudinally:ab,ti OR ‘prospective’:ab,ti OR prospectively:ab,ti OR ‘retrospective’:ab,ti OR ‘follow up’/exp OR ‘follow up’:ab,ti OR ‘comparative study’/exp OR ‘comparative study’:ab,ti OR ‘comparative studies’:ab,ti OR ‘systematic review’:ab,ti OR ‘meta-analysis’:ab,ti OR ‘meta-analyses’:ab,ti OR ‘meta synthesis’:ab,ti OR ‘meta syntheses’:ab,ti OR ‘survival analysis’/exp OR ‘multicenter study’/exp OR ‘multicenter study’:ab,ti OR multicentre:ab,ti OR ‘register’/exp OR registry:ab,ti OR registries:ab,ti OR ‘sensitivity and specificity’/exp OR sensitivity:ab,ti OR specificity:ab,ti OR valid:ab,ti OR validity:ab,ti OR validation:ab,ti OR ‘validation study’/exp |
| #9 | #7 AND #8 |
| #10 | #9 AND [1-8-2011]/sd |
| #11 | #10 AND [embase]/lim NOT [medline]/lim |
KQ 3: What are the comparative safety and effectiveness of specific anticoagulation therapies, antiplatelet therapies, and procedural interventions for preventing thromboembolic events:
- a)
In patients with nonvalvular atrial fibrillation?
- b)
In specific subpopulations of patients with nonvalvular atrial fibrillation?
| #1 | ‘atrial fibrillation’/exp OR ‘heart atrium flutter’/exp OR ‘atrial fibrillation’:ab,ti OR ‘atrial flutter’:ab,ti |
| #2 | ‘cerebrovascular disease’/de OR ‘cerebrovascular accident’/exp OR ‘thromboembolism’/exp OR ‘bleeding’/de OR ‘brain hemorrhage’/exp OR ‘brain ischemia’/exp OR ‘prothrombin time’/exp OR stroke:ab,ti OR strokes:ab,ti OR thromboembolism:ab,ti OR thromboembolisms:ab,ti OR thromboembolic:ab,ti OR thromboses:ab,ti OR hemorrhage:ab,ti OR hemorrhages:ab,ti OR hemorrhaging:ab,ti OR hemorrhagic:ab,ti OR haemorrhage:ab,ti OR haemorrhages:ab,ti OR haemorrhaging:ab,ti OR haemorrhagic:ab,ti OR ((bleeding OR bleed OR bleeds) NEAR/2 (major OR risk OR event)):ab,ti OR ((systemic OR paradoxical OR crossed) NEXT/2 (embolism OR embolisms)):ab,ti OR ((brain OR cerebral OR brainstem OR ‘brain stem’) NEXT/2 (ischemia OR ischaemia OR ischemias OR ischaemias OR infarction OR infarctions)):ab,ti OR (transient NEXT/2 (ischemic OR ischaemic OR ischaemia OR ischemia) NEXT/2 (attack OR attacks)):ab,ti OR tia:ab,ti OR tias:ab,ti OR ‘cerebrovascular accident’:ab,ti OR ‘cerebrovascular accidents’:ab,ti OR cva:ab,ti OR cvas:ab,ti OR ‘brain vascular accident’:ab,ti OR ‘brain vascular accidents’:ab,ti |
| #3 | ‘risk’/exp OR risk:ab,ti OR risks:ab,ti OR ‘safety’/exp OR safety:ab,ti OR safe:ab,ti OR ‘incidence’/exp OR efficacy:ab,ti OR efficacious:ab,ti OR ‘prevention’:lnk OR prevent:ab,ti OR prevents:ab,ti OR preventing:ab,ti OR prevention:ab,ti OR ‘treatment outcome’/exp OR ‘adverse drug reaction’:lnk OR (side NEXT/1 effect*):ab,ti OR (adverse NEXT/3 (interaction* OR response* OR effect* OR event* OR reaction* OR outcome*)):ab,ti OR (unintended NEXT/3 (interaction* OR response* OR effect* OR event* OR reaction* OR outcome*)):ab,ti OR (unintentional NEXT/3 (interaction* OR response* OR effect* OR event* OR reaction* OR outcome*)):ab,ti OR (unwanted NEXT/3 (interaction* OR response* OR effect* OR event* OR reaction* OR outcome*)):ab,ti OR (unexpected NEXT/3 (interaction* OR response* OR effect* OR event* OR reaction* OR outcome*)):ab,ti OR (undesirable NEXT/3 (interaction* OR response* OR effect* OR event* OR reaction* OR outcome*)):ab,ti OR ‘drug safety’:ab,ti OR ‘drug toxicity’:ab,ti OR tolerability:ab,ti OR harm:ab,ti OR harms:ab,ti OR harmful:ab,ti OR ‘treatment emergent’:ab,ti OR complication*:ab,ti OR toxicity:ab,ti |
| #4 | #1 AND #2 AND #3 |
| #5 | ‘anticoagulant agent’/exp OR warfarin:ab,ti OR coumadin:ab,ti OR ‘vitamin k’:ab,ti OR enoxaparin:ab,ti OR lovenox:ab,ti OR rivaroxaban:ab,ti OR xarelto:ab,ti OR dabigatran:ab,ti OR pradaxa:ab,ti OR heparin:ab,ti OR apixaban:ab,ti OR eliquis:ab,ti OR edoxaban:ab,ti OR lixiana:ab,ti OR anticoagulant:ab,ti OR anticoagulants:ab,ti OR anticoagulation:ab,ti OR ‘thrombin inhibitor’:ab,ti OR ‘thrombin inhibitors’:ab,ti OR antithrombin:ab,ti OR antithrombins:ab,ti OR antithrombotic:ab,ti OR ‘factor Xa inhibitor’:ab,ti OR ‘factor Xa inhibitors’:ab,ti OR ‘Blood clotting inhibitor’:ab,ti OR ‘blood clotting inhibitors’:ab,ti OR clopidogrel:ab,ti OR plavix:ab,ti OR aspirin:ab,ti OR dipyridamole:ab,ti OR aggrenox:ab,ti OR persantine:ab,ti OR curantil:ab,ti OR antiplatelet:ab,ti OR anti-platelet:ab,ti OR antiplatelets:ab,ti OR anti-platelets:ab,ti OR ‘platelet aggregation inhibitors’:ab,ti OR ‘platelet aggregation inhibitor’:ab,ti OR ‘platelet inhibitors’:ab,ti OR ‘platelet inhibitor’:ab,ti OR ‘platelet antagonists’:ab,ti OR ‘platelet antagonist’:ab,ti |
| #6 | (‘heart atrium appendage’/de AND ‘surgery’:lnk) OR ‘septal occluder’/exp OR ‘atrial appendage’:ab,ti OR ‘atrial appendages’:ab,ti OR ‘atrium appendage’:ab,ti OR ‘auricular appendage’:ab,ti OR ‘auricular appendages’:ab,ti OR LAA:ab,ti OR occluder:ab,ti OR occluders:ab,ti OR occlusion:ab,ti OR AMPLATZER:ab,ti OR AtriClip:ab,ti OR PLAATO:ab,ti OR Watchman:ab,ti OR (atrial:ab,ti AND modification:ab,ti) OR lariat:ab,ti OR atricure:ab,ti |
| #7 | #4 AND (#5 OR #6) |
| #8 | #7 NOT (‘case report’/exp OR ‘case study’/exp OR ‘editorial’/exp OR ‘letter’/exp OR ‘note’/exp OR [conference abstract]/lim) |
| #9 | #8 AND [humans]/lim |
| #10 | #9 NOT ((‘adolescent’/exp OR ‘child’/exp) NOT ‘adult’/exp) |
| #11 | ‘clinical trial’/exp OR ‘clinical study’/exp OR ‘controlled study’/exp OR randomized:ab,ti OR randomised:ab,ti OR randomization:ab,ti OR randomisation:ab,ti OR randomly:ab,ti OR placebo:ab,ti OR trial:ab,ti OR groups:ab,ti OR ‘crossover procedure’/exp OR ‘double blind procedure’/exp OR ‘single blind procedure’/exp OR crossover*:ab,ti OR (cross NEXT/1 over*):ab,ti OR ‘clinical trial’:ab,ti OR ‘clinical trials’:ab,ti OR ‘clinical study’:ab,ti OR ‘clinical studies’:ab,ti OR ‘evaluation study’/exp OR ‘evaluation study’:ab,ti OR ‘evaluation studies’:ab,ti OR ‘intervention study’:ab,ti OR ‘intervention studies’:ab,ti OR ‘case-control’:ab,ti OR ‘cohort analysis’/exp OR cohort:ab,ti OR longitudinal:ab,ti OR longitudinally:ab,ti OR ‘prospective’:ab,ti OR prospectively:ab,ti OR ‘retrospective’:ab,ti OR ‘follow up’/exp OR ‘follow up’:ab,ti OR ‘comparative study’/exp OR ‘comparative study’:ab,ti OR ‘comparative studies’:ab,ti OR ‘systematic review’:ab,ti OR ‘meta-analysis’:ab,ti OR ‘meta-analyses’:ab,ti OR ‘meta synthesis’:ab,ti OR ‘meta syntheses’:ab,ti OR ‘survival analysis’/exp OR ‘multicenter study’/exp OR ‘multicenter study’:ab,ti OR multicentre:ab,ti OR ‘register’/exp OR registry:ab,ti OR registries:ab,ti OR ‘sensitivity and specificity’/exp OR sensitivity:ab,ti OR specificity:ab,ti OR valid:ab,ti OR validity:ab,ti OR validation:ab,ti OR ‘validation study’/exp |
| #12 | #10 AND #11 |
| #13 | #12 AND [1-8-2011]/sd |
| #14 | #13 AND [embase]/lim NOT [medline]/lim |
Embase® Search Strategy (August 14, 2012)
Platform: Embase.com
KQ 1: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of available clinical and imaging tools for predicting thromboembolic risk?
| #1 | ‘heart atrium fibrillation’/exp OR ‘heart atrium flutter’/exp OR “atrial fibrillation”:ab,ti OR (atrial:ab,ti AND fibrillation:ab,ti) OR afib:ab,ti OR “atrial flutter”:ab,ti |
| #2 | ‘nuclear magnetic resonance imaging’/exp OR ‘cardiac imaging’/exp OR ‘computer assisted tomography’/exp OR ‘echocardiography’/exp OR chads2:ab,ti OR ‘chads2 vasc’:ab,ti OR (transthoracic:ab,ti AND echo:ab,ti) OR (transesophageal:ab,ti AND echo:ab,ti) OR tte:ab,ti OR tee:ab,ti OR ‘ct scan’:ab,ti |
| #3 | ‘stroke’/exp OR ‘thromboembolism’/exp OR ‘brain ischemia’/exp OR stroke:ab,ti OR thromboembolism:ab,ti OR thromboembolic:ab,ti OR (brain:ab,ti AND ischemia:ab,ti) OR (brain:ab,ti AND ischaemia:ab,ti) OR (transient:ab,ti AND (ischemic:ab,ti OR ischaemic:ab,ti OR ischaemia:ab,ti OR ischemia:ab,ti) AND attack:ab,ti) OR TIA:ab,ti |
| #4 | #1 AND #2 AND #3 |
| #5 | ‘diagnosis’/exp OR ‘treatment outcome’/exp OR ‘sensitivity and specificity’/exp OR ‘clinical decision making’/exp OR ‘decision making’/exp OR diagnosis:ab,ti OR outcome:ab,ti OR outcomes:ab,ti OR reliability:ab,ti OR accuracy:ab,ti OR accurate:ab,ti OR Sensitivity:ab,ti OR specificity:ab,ti OR valid:ab,ti OR validity:ab,ti OR validation:ab,ti OR decision:ab,ti OR decisions:ab,ti OR assessment:ab,ti |
| #6 | #5 AND #4 |
| #7 | #6 Limits: Humans, English, 2000 - present |
| #8 | #7 AND [embase]/lim NOT [medline]/lim |
KQ 2: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of clinical tools and associated risk factors for predicting bleeding events?
| #1 | ‘heart atrium fibrillation’/exp OR ‘heart atrium flutter’/exp OR “atrial fibrillation”:ab,ti OR (atrial:ab,ti AND fibrillation:ab,ti) OR afib:ab,ti OR “atrial flutter”:ab,ti |
| #2 | ‘age’/exp OR ‘dementia’/exp OR ‘falling’/exp OR ‘international normalized ratio’/exp OR “age factors”:ab,ti OR “age factor”:ab,ti OR age:ab,ti OR dementia:ab,ti OR INR:ab,ti OR fall:ab,ti OR falls:ab,ti OR “international normalized ratio”:ab,ti OR paroxysmal:ab,ti OR persistent:ab,ti OR permanent:ab,ti OR stratification:ab,ti OR classification:ab,ti OR schema:ab,ti OR has-bled:ab,ti OR (cognitive:ab,ti AND impairment:ab,ti) OR cognition:ab,ti OR ((prior:ab,ti OR previous:ab,ti OR first:ab,ti) AND stroke:ab,ti) |
| #3 | ‘brain hemorrhage’/exp OR ‘bleeding’/exp OR hemorrhage:ab,ti OR hemorrhaging:ab,ti OR bleeding:ab,ti OR bleed:ab,ti OR hemorrhagic:ab,ti OR haemorrhage:ab,ti OR haemorrhaging:ab,ti OR haemorrhagic:ab,ti |
| #4 | #1 AND #2 AND #3 |
| #5 | ‘diagnosis’/exp OR ‘treatment outcome’/exp OR ‘sensitivity and specificity’/exp OR ‘clinical decision making’/exp OR ‘decision making’/exp OR diagnosis:ab,ti OR outcome:ab,ti OR outcomes:ab,ti OR reliability:ab,ti OR accuracy:ab,ti OR accurate:ab,ti OR Sensitivity:ab,ti OR specificity:ab,ti OR valid:ab,ti OR validity:ab,ti OR validation:ab,ti OR decision:ab,ti OR decisions:ab,ti OR assessment:ab,ti |
| #6 | #5 AND #4 |
| #7 | #6 Limits: Humans, English, 2000 - present |
| #8 | #7 AND [embase]/lim NOT [medline]/lim |
KQ 3: What are the comparative safety and effectiveness of specific anticoagulation therapies, antiplatelet therapies, and procedural interventions for preventing thromboembolic events:
- (a)
In patients with nonvalvular atrial fibrillation?
- (b)
In specific subpopulations of patients with nonvalvular atrial fibrillation?
| #1 | ‘heart atrium fibrillation’/exp OR ‘heart atrium flutter’/exp OR “atrial fibrillation”:ab,ti OR (atrial:ab,ti AND fibrillation:ab,ti) OR afib:ab,ti OR “atrial flutter”:ab,ti |
| #2 | ‘anticoagulant agent’/exp OR ‘warfarin’/exp OR ‘vitamin K group’/exp OR ‘heparin’/exp OR ‘enoxaparin’/exp OR ‘rivaroxaban’/exp OR ‘dabigatran etexilate’/exp OR ‘apixaban’/exp OR ‘edoxaban’/exp |
| #3 | warfarin:ab,ti OR coumadin:ab,ti OR vitamin k:ab,ti OR enoxaparin:ab,ti OR lovenox:ab,ti OR rivaroxaban:ab,ti OR xarelto:ab,ti OR dabigatran:ab,ti OR pradaxa:ab,ti OR heparin:ab,ti OR apixaban:ab,ti OR eliquis:ab,ti OR edoxaban:ab,ti OR lixiana:ab,ti |
| #4 | #2 OR #3 |
| #5 | ‘antithrombocytic agent’/exp OR ‘clopidogrel’/exp OR ‘acetylsalicylic acid’/exp OR ‘dipyridamole’/exp OR clopidogrel:ab,ti OR plavix:ab,ti OR aspirin:ab,ti OR dipyridamole:ab,ti OR aggrenox:ab,ti OR persantine:ab,ti OR antiplatelet:ab,ti OR anti-platelet:ab,ti OR antiplatelets:ab,ti OR anti-platelets:ab,ti |
| #6 | ‘heart atrium appendage’/exp OR atrial appendage:ab,ti OR LAA:ab,ti OR occluder:ab,ti OR AMPLATZER:ab,ti OR AtriClip:ab,ti OR PLAATO:ab,ti OR Watchman:ab,ti OR (atrial:ab,ti AND modification:ab,ti) OR “atriacure isolator”:ab,ti |
| #7 | ‘stroke’/exp OR ‘thromboembolism’/exp OR ‘brain ischemia’/exp OR stroke:ab,ti OR thromboembolism:ab,ti OR thromboembolic:ab,ti OR (brain:ab,ti AND ischemia:ab,ti) OR (brain:ab,ti AND ischaemia:ab,ti) OR (transient:ab,ti AND (ischemic:ab,ti OR ischaemic:ab,ti OR ischaemia:ab,ti OR ischemia:ab,ti) AND attack:ab,ti) OR TIA:ab,ti |
| #8 | #1 AND (#4 OR #5 OR #6) AND #7 |
| #9 | (‘randomized controlled trial’/exp OR ‘crossover procedure’/exp OR ‘double blind procedure’/exp OR ‘single blind procedure’/exp OR random*:ab,ti OR factorial*:ab,ti OR crossover*:ab,ti OR (cross NEAR/1 over*):ab,ti OR placebo*:ab,ti OR (doubl* NEAR/1 blind*):ab,ti OR (singl* NEAR/1 blind*):ab,ti OR assign*:ab,ti OR allocat*:ab,ti OR volunteer*:ab,ti OR ‘clinical study’/exp OR “clinical trial”:ti,ab OR “clinical trials”:ti,ab OR ‘controlled study’/exp OR ‘evaluation’/exp OR “evaluation study”:ab,ti OR “evaluation studies”:ab,ti OR “intervention study”:ab,ti OR “intervention studies”:ab,ti OR “case control”:ab,ti OR ‘cohort analysis’/exp OR cohort:ab,ti OR longitudinal*:ab,ti OR prospective:ab,ti OR prospectively:ab,ti OR retrospective:ab,ti OR ‘follow up’/exp OR “follow up”:ab,ti OR ‘comparative effectiveness’/exp OR ‘comparative study’/exp OR “comparative study”:ab,ti OR “comparative studies”:ab,ti OR ‘evidence based medicine’/exp OR “systematic review”:ab,ti OR “meta-analysis”:ab,ti OR “meta-analyses”:ab,ti) NOT (‘editorial’/exp OR ‘letter’/exp OR ‘case report’/exp) |
| #10 | #8 AND #9 |
| #11 | #10 Limits: Humans, English, 2000 - present |
| #12 | #11 AND [embase]/lim NOT [medline]/lim |
KQ 4: What are the comparative safety and effectiveness of available strategies for anticoagulation in patients with nonvalvular atrial fibrillation who are undergoing invasive procedures?
| #1 | ‘heart atrium fibrillation’/exp OR ‘heart atrium flutter’/exp OR “atrial fibrillation”:ab,ti OR (atrial:ab,ti AND fibrillation:ab,ti) OR afib:ab,ti OR “atrial flutter”:ab,ti |
| #2 | ‘anticoagulant agent’/exp OR ‘warfarin’/exp OR ‘vitamin K group’/exp OR ‘heparin’/exp OR ‘enoxaparin’/exp OR ‘rivaroxaban’/exp OR ‘dabigatran etexilate’/exp OR ‘apixaban’/exp OR ‘edoxaban’/exp |
| #3 | warfarin:ab,ti OR coumadin:ab,ti OR vitamin k:ab,ti OR enoxaparin:ab,ti OR lovenox:ab,ti OR rivaroxaban:ab,ti OR xarelto:ab,ti OR dabigatran:ab,ti OR pradaxa:ab,ti OR heparin:ab,ti OR apixaban:ab,ti OR eliquis:ab,ti OR edoxaban:ab,ti OR lixiana:ab,ti |
| #4 | #2 OR #3 |
| #5 | ‘surgery’/exp OR ‘dental care’/exp OR ((surgical:ab,ti OR invasive:ab,ti) AND (procedure:ab,ti OR procedures:ab,ti)) OR (dental:ab,ti AND (procedure:ab,ti OR procedures:ab,ti)) OR surgery:ab,ti OR procedures:ab,ti OR procedure:ab,ti |
| #6 | #1 AND #4 AND #5 |
| #7 | (‘randomized controlled trial’/exp OR ‘crossover procedure’/exp OR ‘double blind procedure’/exp OR ‘single blind procedure’/exp OR random*:ab,ti OR factorial*:ab,ti OR crossover*:ab,ti OR (cross NEAR/1 over*):ab,ti OR placebo*:ab,ti OR (doubl* NEAR/1 blind*):ab,ti OR (singl* NEAR/1 blind*):ab,ti OR assign*:ab,ti OR allocat*:ab,ti OR volunteer*:ab,ti OR ‘clinical study’/exp OR “clinical trial”:ti,ab OR “clinical trials”:ti,ab OR ‘controlled study’/exp OR ‘evaluation’/exp OR “evaluation study”:ab,ti OR “evaluation studies”:ab,ti OR “intervention study”:ab,ti OR “intervention studies”:ab,ti OR “case control”:ab,ti OR ‘cohort analysis’/exp OR cohort:ab,ti OR longitudinal*:ab,ti OR prospective:ab,ti OR prospectively:ab,ti OR retrospective:ab,ti OR ‘follow up’/exp OR “follow up”:ab,ti OR ‘comparative effectiveness’/exp OR ‘comparative study’/exp OR “comparative study”:ab,ti OR “comparative studies”:ab,ti OR ‘evidence based medicine’/exp OR “systematic review”:ab,ti OR “meta-analysis”:ab,ti OR “meta-analyses”:ab,ti) NOT (‘editorial’/exp OR ‘letter’/exp OR ‘case report’/exp) |
| #8 | #6 AND #7 |
| #9 | #8 Limits: Humans, English, 2000 - present |
| #10 | #9 AND [embase]/lim NOT [medline]/lim |
KQ 5: What are the comparative safety and effectiveness of available strategies for switching between warfarin and other novel oral anticoagulants, in patients with nonvalvular atrial fibrillation?
| #1 | ‘heart atrium fibrillation’/exp OR ‘heart atrium flutter’/exp OR “atrial fibrillation”:ab,ti OR (atrial:ab,ti AND fibrillation:ab,ti) OR afib:ab,ti OR “atrial flutter”:ab,ti |
| #2 | ‘warfarin’/exp OR warfarin:ab,ti OR coumadin:ab,ti |
| #3 | antithrombins:ab,ti OR (direct:ab,ti AND thrombin:ab,ti AND inhibitors:ab,ti) OR (direct:ab,ti AND thrombin:ab,ti AND inhibitor:ab,ti) OR “direct thrombin inhibitors”:ab,ti OR “Antithrombin III”:ab,ti OR “Antithrombin Proteins”:ab,ti OR argatroban:ab,ti OR bivalirudin:ab,ti OR “Heparin Cofactor II”:ab,ti OR Hirudins:ab,ti OR inogatran:ab,ti OR lepirudin:ab,ti OR melagatran:ab,ti OR “SDZ MTH 958”:ab,ti OR ximelagatran:ab,ti |
| #4 | ‘anticoagulant agent’/exp OR anticoagulant:ab,ti OR anticoagulants:ab,ti |
| #5 | (‘randomized controlled trial’/exp OR ‘crossover procedure’/exp OR ‘double blind procedure’/exp OR ‘single blind procedure’/exp OR random*:ab,ti OR factorial*:ab,ti OR crossover*:ab,ti OR (cross NEAR/1 over*):ab,ti OR placebo*:ab,ti OR (doubl* NEAR/1 blind*):ab,ti OR (singl* NEAR/1 blind*):ab,ti OR assign*:ab,ti OR allocat*:ab,ti OR volunteer*:ab,ti OR ‘clinical study’/exp OR “clinical trial”:ti,ab OR “clinical trials”:ti,ab OR ‘controlled study’/exp OR ‘evaluation’/exp OR “evaluation study”:ab,ti OR “evaluation studies”:ab,ti OR “intervention study”:ab,ti OR “intervention studies”:ab,ti OR “case control”:ab,ti OR ‘cohort analysis’/exp OR cohort:ab,ti OR longitudinal*:ab,ti OR prospective:ab,ti OR prospectively:ab,ti OR retrospective:ab,ti OR ‘follow up’/exp OR “follow up”:ab,ti OR ‘comparative effectiveness’/exp OR ‘comparative study’/exp OR “comparative study”:ab,ti OR “comparative studies”:ab,ti OR ‘evidence based medicine’/exp OR “systematic review”:ab,ti OR “meta-analysis”:ab,ti OR “meta-analyses”:ab,ti) NOT (‘editorial’/exp OR ‘letter’/exp OR ‘case report’/exp) |
| #6 | #1 AND #2 AND (#3 OR #4) AND #5 |
| #7 | #6 Limits: Humans, English, 2000 - present |
| #8 | #7 AND [embase]/lim NOT [medline]/lim |
KQ 6: What are the comparative safety and effectiveness of available strategies for resuming anticoagulation therapy or performing a procedural intervention as a stroke prevention strategy following a hemorrhagic event (stroke, major bleed, or minor bleed) in patients with nonvalvular atrial fibrillation?
| #1 | ‘heart atrium fibrillation’/exp OR ‘heart atrium flutter’/exp OR “atrial fibrillation”:ab,ti OR (atrial:ab,ti AND fibrillation:ab,ti) OR afib:ab,ti OR “atrial flutter”:ab,ti |
| #2 | ‘anticoagulant agent’/exp OR ‘warfarin’/exp OR ‘vitamin K group’/exp OR ‘heparin’/exp OR ‘enoxaparin’/exp OR ‘rivaroxaban’/exp OR ‘dabigatran etexilate’/exp OR ‘apixaban’/exp OR ‘edoxaban’/exp |
| #3 | warfarin:ab,ti OR coumadin:ab,ti OR vitamin k:ab,ti OR enoxaparin:ab,ti OR lovenox:ab,ti OR rivaroxaban:ab,ti OR xarelto:ab,ti OR dabigatran:ab,ti OR pradaxa:ab,ti OR heparin:ab,ti OR apixaban:ab,ti OR eliquis:ab,ti OR edoxaban:ab,ti OR lixiana:ab,ti |
| #4 | #2 OR #3 |
| #5 | ‘brain hemorrhage’/exp OR ‘bleeding’/exp OR hemorrhage:ab,ti OR hemorrhaging:ab,ti OR bleeding:ab,ti OR bleed:ab,ti OR hemorrhagic:ab,ti OR haemorrhage:ab,ti OR haemorrhaging:ab,ti OR haemorrhagic:ab,ti |
| #6 | ‘time’/exp OR resume:ab,ti OR resumed:ab,ti OR restart:ab,ti OR restarted:ab,ti OR restarting:ab,ti OR re-initiate:ab,ti OR reinitiate:ab,ti OR continue:ab,ti OR continued:ab,ti OR start:ab,ti OR resumption:ab,ti OR reinitiating:ab,ti OR resuming:ab,ti OR continuing:ab,ti |
| #7 | #1 AND #4 AND #5 AND #6 |
| #8 | (‘randomized controlled trial’/exp OR ‘crossover procedure’/exp OR ‘double blind procedure’/exp OR ‘single blind procedure’/exp OR random*:ab,ti OR factorial*:ab,ti OR crossover*:ab,ti OR (cross NEAR/1 over*):ab,ti OR placebo*:ab,ti OR (doubl* NEAR/1 blind*):ab,ti OR (singl* NEAR/1 blind*):ab,ti OR assign*:ab,ti OR allocat*:ab,ti OR volunteer*:ab,ti OR ‘clinical study’/exp OR “clinical trial”:ti,ab OR “clinical trials”:ti,ab OR ‘controlled study’/exp OR ‘evaluation’/exp OR “evaluation study”:ab,ti OR “evaluation studies”:ab,ti OR “intervention study”:ab,ti OR “intervention studies”:ab,ti OR “case control”:ab,ti OR ‘cohort analysis’/exp OR cohort:ab,ti OR longitudinal*:ab,ti OR prospective:ab,ti OR prospectively:ab,ti OR retrospective:ab,ti OR ‘follow up’/exp OR “follow up”:ab,ti OR ‘comparative effectiveness’/exp OR ‘comparative study’/exp OR “comparative study”:ab,ti OR “comparative studies”:ab,ti OR ‘evidence based medicine’/exp OR “systematic review”:ab,ti OR “meta-analysis”:ab,ti OR “meta-analyses”:ab,ti) NOT (‘editorial’/exp OR ‘letter’/exp OR ‘case report’/exp) |
| #9 | #7 AND #8 |
| #10 | #9 Limits: Humans, English, 2000 - present |
| #11 | #10 AND [embase]/lim NOT [medline]/lim |
Cochrane Search Strategy (February 14, 2018)
Platform: Wiley
Database searched: Cochrane Database of Systematic Reviews
KQ 1 & KQ 2: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic and patient outcome efficacy) of available clinical and imaging tools and associated risk factors for predictin thromboembolic risk? & In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of clinical tools and associated risk factos for predicting bleeding events?
| #1 | [mh “Atrial Fibrillation”] OR “atrial fibrillation”:ab,ti OR [mh “Atrial Flutter”] OR “atrial flutter”:ab,ti |
| #2 | [mh ^"Cerebrovascular Disorders”[mj]] or [mh Stroke] or [mh Thromboembolism] or [mh ^Hemorrhage] or [mh “Intracranial Hemorrhages”] or [mh “Brain Ischemia”] or [mh “Prothrombin Time”] or stroke:ab,ti or strokes:ab,ti or thromboembolism:ab,ti or thromboembolisms:ab,ti or thromboembolic:ab,ti or thromboses:ab,ti or hemorrhage:ab,ti or hemorrhages:ab,ti or hemorrhaging:ab,ti or hemorrhagic:ab,ti or haemorrhage:ab,ti or haemorrhages:ab,ti or haemorrhaging:ab,ti or haemorrhagic:ab,ti or ((bleeding or bleed or bleeds) near/2 (major or risk or event)):ab,ti or ((systemic or paradoxical or crossed) next/2 (embolism or embolisms)):ab,ti or ((brain or cerebral or brainstem or ‘brain stem’) next/2 (ischemia or ischaemia or ischemias or ischaemias or infarction or infarctions)):ab,ti or (transient next/2 (ischemic or ischaemic or ischaemia or ischemia) next/2 (attack or attacks)):ab,ti or TIA:ab,ti or TIAs:ab,ti or “cerebrovascular accident”:ab,ti or “cerebrovascular accidents”:ab,ti or CVA:ab,ti or CVAs:ab,ti or “brain vascular accident”:ab,ti or “brain vascular accidents”:ab,ti |
| #3 | [mh Risk] or risk:ab,ti or risks:ab,ti or [mh “Predictive Value of Tests”] or predict:ab,ti or predicts:ab,ti or predicting:ab,ti or predictor:ab,ti or predictors:ab,ti or predictive:ab,ti |
| #4 | {and #1-#3} |
| #5 | #4 Publication Year from 2011 |
KQ 3: What are the comparative safety and effectiveness of specific anticoagulation therapies, antiplatelet therapies, and procedural interventions for preventing thromboembolic events:
- a)
In patients with nonvalvular atrial fibrillation?
- b)
In specific subpopulations of patients with nonvalvular atrial fibrillation?
| #1 | [mh “Atrial Fibrillation”] OR “atrial fibrillation”:ab,ti OR [mh “Atrial Flutter”] OR “atrial flutter”:ab,ti |
| #2 | [mh ^"Cerebrovascular Disorders”[mj]] or [mh Stroke] or [mh Thromboembolism] or [mh ^Hemorrhage] or [mh “Intracranial Hemorrhages”] or [mh “Brain Ischemia”] or [mh “Prothrombin Time”] or stroke:ab,ti or strokes:ab,ti or thromboembolism:ab,ti or thromboembolisms:ab,ti or thromboembolic:ab,ti or thromboses:ab,ti or hemorrhage:ab,ti or hemorrhages:ab,ti or hemorrhaging:ab,ti or hemorrhagic:ab,ti or haemorrhage:ab,ti or haemorrhages:ab,ti or haemorrhaging:ab,ti or haemorrhagic:ab,ti or ((bleeding or bleed or bleeds) near/2 (major or risk or event)):ab,ti or ((systemic or paradoxical or crossed) next/2 (embolism or embolisms)):ab,ti or ((brain or cerebral or brainstem or ‘brain stem’) next/2 (ischemia or ischaemia or ischemias or ischaemias or infarction or infarctions)):ab,ti or (transient next/2 (ischemic or ischaemic or ischaemia or ischemia) next/2 (attack or attacks)):ab,ti or TIA:ab,ti or TIAs:ab,ti or “cerebrovascular accident”:ab,ti or “cerebrovascular accidents”:ab,ti or CVA:ab,ti or CVAs:ab,ti or “brain vascular accident”:ab,ti or “brain vascular accidents”:ab,ti |
| #3 | [mh Risk] or risk:ab,ti or risks:ab,ti or [mh Safety] or safety:ab,ti or safe:ab,ti or [mh Incidence] or efficacy:ab,ti or efficacious:ab,ti or [mh /PC] or prevent:ab,ti or prevents:ab,ti or preventing:ab,ti or prevention:ab,ti or [mh “Treatment Outcome”] or [mh /AE] or (side next/1 effect*):ab,ti or (adverse next/3 (interaction* or response* or effect* or event* or reaction* or outcome*)):ab,ti or (unintended next/3 (interaction* or response* or effect* or event* or reaction* or outcome*)):ab,ti or (unintentional next/3 (interaction* or response* or effect* or event* or reaction* or outcome*)):ab,ti or (unwanted next/3 (interaction* or response* or effect* or event* or reaction* or outcome*)):ab,ti or (unexpected next/3 (interaction* or response* or effect* or event* or reaction* or outcome*)):ab,ti or (undesirable next/3 (interaction* or response* or effect* or event* or reaction* or outcome*)):ab,ti or “drug safety”:ab,ti or “drug toxicity”:ab,ti or tolerability:ab,ti or harm:ab,ti or harms:ab,ti or harmful:ab,ti or “treatment emergent”:ab,ti or complication*:ab,ti or toxicity:ab,ti |
| #4 | {and #1-#3} |
| #5 | [mh Anticoagulants] or [mh Warfarin] or [mh Heparin] or [mh “Vitamin K”/AI] or [mh Rivaroxaban] or [mh Antithrombins] or [mh Dabigatran] or [mh “Blood Coagulation Factor Inhibitors”] or [mh “Factor Xa Inhibitors”] or warfarin:ab,ti or coumadin:ab,ti or “vitamin k”:ab,ti or enoxaparin:ab,ti or lovenox:ab,ti or rivaroxaban:ab,ti or xarelto:ab,ti or dabigatran:ab,ti or pradaxa:ab,ti or heparin:ab,ti or apixaban:ab,ti or eliquis:ab,ti or edoxaban:ab,ti or lixiana:ab,ti or anticoagulant:ab,ti or anticoagulants:ab,ti or anticoagulation:ab,ti or “thrombin inhibitor”:ab,ti or “thrombin inhibitors”:ab,ti or antithrombin:ab,ti or antithrombins:ab,ti or antithrombotic:ab,ti or “factor Xa inhibitor”:ab,ti or “factor Xa inhibitors”:ab,ti or “Blood clotting inhibitor”:ab,ti or “blood clotting inhibitors”:ab,ti |
| #6 | [mh “Platelet Aggregation Inhibitors”] or [mh Aspirin] or [mh Dipyridamole] or clopidogrel:ab,ti or plavix:ab,ti or aspirin:ab,ti or dipyridamole:ab,ti or aggrenox:ab,ti or persantine:ab,ti or curantil:ab,ti or antiplatelet:ab,ti or anti-platelet:ab,ti or antiplatelets:ab,ti or anti-platelets:ab,ti or “platelet aggregation inhibitors”:ab,ti or “platelet aggregation inhibitor”:ab,ti or “platelet inhibitors”:ab,ti or “platelet inhibitor”:ab,ti or “platelet antagonists”:ab,ti or “platelet antagonist”:ab,ti |
| #7 | [mh “atrial appendage”/SU] or [mh “Septal Occluder Device”] or “atrial appendage”:ab,ti or “atrial appendages”:ab,ti or “atrium appendage”:ab,ti or “auricular appendage”:ab,ti or “auricular appendages”:ab,ti or LAA:ab,ti or occluder:ab,ti or occluders:ab,ti or occlusion:ab,ti or AMPLATZER:ab,ti or AtriClip:ab,ti or PLAATO:ab,ti or Watchman:ab,ti or (atrial:ab,ti and modification:ab,ti) or lariat:ab,ti or atricure:ab,ti |
| #8 | #4 and {or #5-#7} |
| #9 | #8 Publication Year from 2011 |
Cochrane Search Strategy (August 14, 2012)
Platform: Wiley
Database searched: Cochrane Database of Systematic Reviews
KQ 1: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of available clinical and imaging tools for predicting thromboembolic risk?
| #1 | (atrial fibrillation OR atrial flutter):ti,ab,kw |
| #2 | Magnetic Resonance Imaging explode all trees OR MeSH descriptor Cardiac Imaging Techniques explode all trees OR MeSH descriptor Tomography, X-Ray Computed explode all trees OR MeSH descriptor Echocardiography explode all trees OR (chads2 OR chads2-vasc OR TEE OR TTE OR ct-scan OR transthoracic echo OR transesophageal echo):ti,ab,kw |
| #3 | MeSH descriptor Stroke explode all trees OR MeSH descriptor Thromboembolism explode all trees OR MeSH descriptor Brain Ischemia explode all trees OR (thromboembolism OR thromboembolic OR brain ischemia OR brain ischaemia OR tia):ti,ab,kw OR (transient ischemic attack):ti,ab,kw or (transient ischaemic attack):ti,ab,kw or (transient ischemia attack):ti,ab,kw or (transient ischaemic attack):ti,ab,kw |
| #4 | #1 AND #2 AND #3 |
| #5 | #4, Limits: Cochrane Reviews, 2000 to 2012 |
KQ 2: In patients with nonvalvular atrial fibrillation, what are the comparative diagnostic accuracy and impact on clinical decisionmaking (diagnostic thinking, therapeutic, and patient outcome efficacy) of clinical tools and associated risk factors for predicting bleeding events?
| #1 | (atrial fibrillation OR atrial flutter):ti,ab,kw |
| #2 | MeSH descriptor Age Factors explode all trees OR MeSH descriptor Dementia explode all trees OR MeSH descriptor Accidental Falls explode all trees OR MeSH descriptor International Normalized Ratio explode all trees OR age:ti,ab,kw OR dementia:ti,ab,kw OR INR:ti,ab,kw OR fall:ti,ab,kw OR falls:ti,ab,kw OR “international normalized ratio”:ti,ab,kw OR paroxysmal:ti,ab,kw OR persistent:ti,ab,kw OR permanent:ti,ab,kw OR stratification:ti,ab,kw OR classification:ti,ab,kw OR schema:ti,ab,kw OR has-bled:ti,ab,kw OR cognitive impairment:ti,ab,kw OR cognition:ti,ab,kw OR ((prior:ti,ab,kw OR previous:ti,ab,kw OR first:ti,ab,kw) AND stroke:ti,ab,kw) |
| #3 | MeSH descriptor Intracranial Hemorrhages explode all trees OR MeSH descriptor Hemorrhage explode all trees OR hemorrhage:ti,ab,kw OR hemorrhaging:ti,ab,kw OR bleeding:ti,ab,kw OR bleed:ti,ab,kw OR hemorrhagic:ti,ab,kw OR haemorrhage:ti,ab,kw OR haemorrhaging:ti,ab,kw OR haemorrhagic:ti,ab,kw |
| #4 | #1 AND #2 AND #3 |
| #5 | MeSH descriptor Diagnosis explode all trees OR MeSH descriptor Treatment Outcome explode all trees OR MeSH descriptor Sensitivity and Specificity explode all trees OR MeSH descriptor Decision Making explode all trees OR diagnosis:ti,ab,kw OR outcome:ti,ab,kw OR outcomes:ti,ab,kw OR reliability:ti,ab,kw OR accuracy:ti,ab,kw OR accurate:ti,ab,kw OR Sensitivity:ti,ab,kw OR specificity:ti,ab,kw OR valid:ti,ab,kw OR validity:ti,ab,kw OR validation:ti,ab,kw OR decision:ti,ab,kw OR decisions:ti,ab,kw OR assessment:ti,ab,kw |
| #6 | #4 AND #5 |
| #7 | #6, Limits: Cochrane Reviews, 2000 to 2012 |
KQ 3: What are the comparative safety and effectiveness of specific anticoagulation therapies, antiplatelet therapies, and procedural interventions for preventing thromboembolic events:
- (a)
In patients with nonvalvular atrial fibrillation?
- (b)
In specific subpopulations of patients with nonvalvular atrial fibrillation?
| #1 | (atrial fibrillation OR atrial flutter):ti,ab,kw |
| #2 | MeSH descriptor Anticoagulants explode all trees OR warfarin:ti,ab,kw OR coumadin:ti,ab,kw OR vitamin k:ti,ab,kw OR enoxaparin:ti,ab,kw OR lovenox:ti,ab,kw OR rivaroxaban:ti,ab,kw OR xarelto:ti,ab,kw OR dabigatran:ti,ab,kw OR pradaxa:ti,ab,kw OR heparin:ti,ab,kw OR apixaban:ti,ab,kw OR eliquis:ti,ab,kw OR edoxaban:ti,ab,kw OR lixiana:ti,ab,kw OR anticoagulants:ti,ab,kw OR OR anticoagulant:ti,ab,kw |
| #3 | MeSH descriptor Platelet Aggregation Inhibitors explode all trees OR clopidogrel:ti,ab,kw OR plavix:ti,ab,kw OR aspirin:ti,ab,kw OR dipyridamole:ti,ab,kw OR aggrenox:ti,ab,kw OR persantine:ti,ab,kw OR antiplatelet:ti,ab,kw OR anti-platelet:ti,ab,kw OR antiplatelets:ti,ab,kw OR anti-platelets:ti,ab,kw |
| #4 | MeSH descriptor Atrial Appendage explode all trees OR atrial appendage:ti,ab,kw OR LAA:ti,ab,kw OR occluder:ti,ab,kw OR AMPLATZER:ti,ab,kw OR AtriClip:ti,ab,kw OR PLAATO:ti,ab,kw OR Watchman:ti,ab,kw OR (atrial:ti,ab,kw AND modification:ti,ab,kw) OR “atriacure isolator”:ti,ab,kw |
| #5 | MeSH descriptor Stroke explode all trees OR MeSH descriptor Thromboembolism explode all trees OR MeSH descriptor Brain Ischemia explode all trees OR (thromboembolism OR thromboembolic OR brain ischemia OR brain ischaemia OR tia):ti,ab,kw OR (transient ischemic attack):ti,ab,kw or (transient ischaemic attack):ti,ab,kw or (transient ischemia attack):ti,ab,kw or (transient ischaemic attack):ti,ab,kw |
| #6 | #1 AND (#2 OR #3 OR #4) AND #5 |
| #7 | #6, Limits: Cochrane Reviews, 2000 to 2012 |
KQ 4: What are the comparative safety and effectiveness of available strategies for anticoagulation in patients with nonvalvular atrial fibrillation who are undergoing invasive procedures?
| #1 | (atrial fibrillation OR atrial flutter):ti,ab,kw |
| #2 | MeSH descriptor Anticoagulants explode all trees OR warfarin:ti,ab,kw OR coumadin:ti,ab,kw OR vitamin k:ti,ab,kw OR enoxaparin:ti,ab,kw OR lovenox:ti,ab,kw OR rivaroxaban:ti,ab,kw OR xarelto:ti,ab,kw OR dabigatran:ti,ab,kw OR pradaxa:ti,ab,kw OR heparin:ti,ab,kw OR apixaban:ti,ab,kw OR eliquis:ti,ab,kw OR edoxaban:ti,ab,kw OR lixiana:ti,ab,kw OR anticoagulants:ti,ab,kw OR OR anticoagulant:ti,ab,kw |
| #3 | MeSH descriptor Surgical Procedures, Operative explode all trees OR MeSH descriptor Dental Care explode all trees OR surgical:ti,ab,kw OR invasive:ti,ab,kw OR procedures:ti,ab,kw OR surgery:ti,ab,kw OR procedure:ti,ab,kw |
| #4 | #1 AND #2 AND #3 |
| #5 | #4, Limits: Cochrane Reviews, 2000 to 2012 |
KQ 5: What are the comparative safety and effectiveness of available strategies for switching between warfarin and other novel oral anticoagulants, in patients with nonvalvular atrial fibrillation?
| #1 | (atrial fibrillation OR atrial flutter):ti,ab,kw |
| #2 | warfarin:ti,ab,kw OR coumadin:ti,ab,kw |
| #3 | MeSH descriptor Antithrombins explode all trees OR antithrombins:ti,ab,kw OR (direct:ti,ab,kw AND thrombin:ti,ab,kw AND inhibitors:ti,ab,kw) OR “direct thrombin inhibitors”:ti,ab,kw OR “direct thrombin inhibitor”:ti,ab,kw |
| #4 | MeSH descriptor Anticoagulants explode all trees OR anticoagulant:ti,ab,kw OR anticoagulants:ti,ab,kw OR vitamin k:ti,ab,kw OR enoxaparin:ti,ab,kw OR lovenox:ti,ab,kw OR rivaroxaban:ti,ab,kw OR xarelto:ti,ab,kw OR dabigatran:ti,ab,kw OR pradaxa:ti,ab,kw OR heparin:ti,ab,kw OR apixaban:ti,ab,kw OR eliquis:ti,ab,kw OR edoxaban:ti,ab,kw OR lixiana:ti,ab,kw |
| #5 | #1 AND #2 AND (#3 OR #4) |
| #6 | #5, Limits: Cochrane Reviews, 2000 to 2012 |
KQ 6: What are the comparative safety and effectiveness of available strategies for resuming anticoagulation therapy or performing a procedural intervention as a stroke prevention strategy following a hemorrhagic event (stroke, major bleed, or minor bleed) in patients with nonvalvular atrial fibrillation?
| #1 | (atrial fibrillation OR atrial flutter):ti,ab,kw |
| #2 | MeSH descriptor Anticoagulants explode all trees OR warfarin:ti,ab,kw OR coumadin:ti,ab,kw OR vitamin k:ti,ab,kw OR enoxaparin:ti,ab,kw OR lovenox:ti,ab,kw OR rivaroxaban:ti,ab,kw OR xarelto:ti,ab,kw OR dabigatran:ti,ab,kw OR pradaxa:ti,ab,kw OR heparin:ti,ab,kw OR apixaban:ti,ab,kw OR eliquis:ti,ab,kw OR edoxaban:ti,ab,kw OR lixiana:ti,ab,kw OR anticoagulant:ti,ab,kw OR anticoagulants:ti,ab,kw |
| #3 | MeSH descriptor Intracranial Hemorrhages explode all trees OR MeSH descriptor Hemorrhage explode all trees OR hemorrhage:ti,ab,kw OR hemorrhaging:ti,ab,kw OR bleeding:ti,ab,kw OR bleed:ti,ab,kw OR hemorrhagic:ti,ab,kw OR haemorrhage:ti,ab,kw OR haemorrhaging:ti,ab,kw OR haemorrhagic:ti,ab,kw |
| #4 | MeSH descriptor Time Factors explode all trees OR Resume:ti,ab,kw OR resumed:ti,ab,kw OR restart:ti,ab,kw OR restarted:ti,ab,kw OR restarting:ti,ab,kw OR re-initiate:ti,ab,kw OR reinitiate:ti,ab,kw OR continue:ti,ab,kw OR continued:ti,ab,kw OR start:ti,ab,kw OR resumption:ti,ab,kw OR reinitiating:ti,ab,kw OR resuming:ti,ab,kw OR continuing:ti,ab,kw |
| #5 | #1 AND #2 AND #3 AND #4 |
| #6 | #5, Limits: Cochrane Reviews, 2000 to 2012 |
PubMed® Search Strategy (February 12, 2018)
Contextual Question: What are currently available shared decision-making tools for patient and provider use for stroke prophylaxis in atrial fibrillation, and what are their relative strengths and weaknesses?
| (((“Atrial Fibrillation”[Mesh] OR “Atrial Flutter”[Mesh] OR “atrial fibrillation”[tiab] OR afib[tiab] OR “atrial flutter”[tiab])) AND (“Stroke”[Mesh] OR “Thromboembolism”[Mesh] OR “brain ischemia”[Mesh] OR stroke[tiab] OR strokes[tiab] OR thromboembolism[tiab] OR thromboembolisms[tiab] OR thromboembolic[tiab] OR ((brain[tiab] OR cerebral[tiab]) AND (ischemia[tiab] OR ischaemia[tiab] OR ischemias[tiab] OR ischaemias[tiab])) OR (transient[tiab] AND (ischemic[tiab] OR ischaemic[tiab] OR ischaemia[tiab] OR ischemia[tiab]) AND (attack[tiab] OR attacks[tiab])) OR TIA[tiab] OR TIAs[tiab] OR “cerebrovascular accident”[tiab] OR “cerebrovascular accidents”[tiab] OR CVA[tiab] OR CVAs[tiab] OR “brain vascular accident”[tiab] OR “brain vascular accidents”[tiab])) AND (”Clinical Decision-Making”[Mesh] OR “Decision Support Systems, Clinical”[Mesh] OR “Decision Making, Computer-Assisted”[Mesh] OR “Decision Support Techniques”[Mesh] OR “Decision Making”[Mesh] OR “Decision Theory”[Mesh] OR “Medical Order Entry Systems”[Mesh] OR “Point-of-Care Systems”[Mesh] OR “decision”[tiab] OR “decision-making”[tiab]) AND (“2011/08/01”[Date - Publication]: “3000”[Date - Publication]) |
Grey Literature Searches
ClinicalTrials.gov (February 9, 2018)
| KQ1, KQ2, KQ3 | |
|---|---|
| Condition | atrial fibrillation OR afib OR atrial flutter |
| Outcome | stroke OR thromboembolism OR thromboembolic OR “brain ischemia” OR “brain ischaemia” OR (transient AND ischemic AND attack) OR TIA OR hemorrhage OR hemorrhaging OR bleeding OR bleed OR hemorrhagic OR haemorrhage OR haemorrhaging OR haemorrhagic |
Total number of results: 343
ClinicalTrials.gov (August 22, 2012)
| KQ1, KQ2, KQ3, KQ6 | |
|---|---|
| Condition | atrial fibrillation OR afib OR atrial flutter |
| Outcome | stroke OR thromboembolism OR thromboembolic OR “brain ischemia” OR “brain ischaemia” OR (transient AND ischemic AND attack) OR TIA OR hemorrhage OR hemorrhaging OR bleeding OR bleed OR hemorrhagic OR haemorrhage OR haemorrhaging OR haemorrhagic |
| KQ4 | |
|---|---|
| Condition | atrial fibrillation OR afib OR atrial flutter |
| Intervention | Anticoagulants OR anticoagulation OR warfarin OR coumadin OR vitamin k OR Heparin OR enoxaparin OR lovenox OR rivaroxaban OR xarelto OR dabigatran OR pradaxa OR apixaban OR eliquis OR edoxaban OR lixiana |
| Search Terms | Surgery OR procedures OR procedure |
| KQ5 | |
|---|---|
| Condition | atrial fibrillation OR afib OR atrial flutter |
| Intervention | (warfarin OR Coumadin) AND (Antithrombins OR antithrombin OR (direct AND thrombin AND (inhibitors OR inhibitor)) OR anticoagulant OR anticoagulants) |
Total number of results: 186
WHO: International Clinical Trials Registry Platform Search Portal (August 17, 2012)
| KQs 1-6 | |
|---|---|
| Condition | atrial fibrillation OR afib OR atrial flutter |
| Recruiting status | ALL |
Total number of results: 858
ProQuest COS Conference Papers Index (August 14, 2012)
| KQ1, KQ2, KQ3, KQ6 | |
|---|---|
| #1 | All (atrial fibrillation OR afib OR atrial flutter) |
| #3 | All (stroke OR thromboembolism OR thromboembolic OR “brain ischemia” OR “brain ischaemia” OR (transient AND (ischemic OR ischaemic) AND attack) OR TIA OR hemorrhage OR hemorrhaging OR bleeding OR bleed OR hemorrhagic OR haemorrhage OR haemorrhaging OR haemorrhagic) |
| #4 | #1 AND #2 AND #3 |
| KQ4 | |
|---|---|
| #1 | All (atrial fibrillation OR afib OR atrial flutter) |
| #2 | All (Anticoagulants OR anticoagulation OR warfarin OR coumadin OR vitamin k OR Heparin OR enoxaparin OR lovenox OR rivaroxaban OR xarelto OR dabigatran OR pradaxa OR apixaban OR eliquis OR edoxaban OR lixiana) |
| #3 | All (Surgery OR procedures OR procedure) |
| #4 | #1 AND #2 AND #3 |
| KQ5 | |
|---|---|
| #1 | All (atrial fibrillation OR afib OR atrial flutter) |
| #2 | All (warfarin OR Coumadin) |
| #3 | All (Antithrombins OR antithrombin OR (direct AND thrombin AND (inhibitors OR inhibitor)) OR anticoagulant OR anticoagulants) |
| #6 | #1 AND #2 AND #3 |
Total number of results: 352
- PubMed® Search Strategy (February 14, 2018)
- PubMed® Search Strategy (August 14, 2012)
- Embase® Search Strategy (February 14, 2018)
- Embase® Search Strategy (August 14, 2012)
- Cochrane Search Strategy (February 14, 2018)
- Cochrane Search Strategy (August 14, 2012)
- PubMed® Search Strategy (February 12, 2018)
- Grey Literature Searches
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