Atrial Fibrillation and Stroke Prevention

Background

Atrial fibrillation (AF) increases the risk of stroke. Anticoagulation medications (OAC) help prevent strokes but may also cause bleeding. Current guidelines don’t clearly suggest whether patients with borderline stroke risk should use OAC. Understanding the risks and benefits can help patients make better decisions.

Study Objective

This study aimed to see if using visual aids and a values clarification exercise helps people understand the trade-offs of using anticoagulation for AF.

Methods

Participants aged 45-64 were recruited online in the U.S. They imagined being newly diagnosed with AF. Participants were divided into three groups: one received standard text information, one received visual aids, and the last group received visual aids plus a values clarification exercise. The main outcome measured was decision confidence, along with perceived stroke risk reduction and likelihood of choosing OAC.

Results

A total of 673 participants completed the survey. Those who saw visual aids had slightly higher decision confidence but were less likely to choose OAC. They also felt that the stroke risk reduction from using OAC was lower compared to those who received standard information. The type of visual aid (gauge vs. icon array) did not significantly change overall results, but preferences varied.

Conclusions

Visual aids can help improve decision confidence and perceptions about OAC benefits, but they do not significantly change decision certainty when guidelines are unclear. Future studies should explore which visual aid works best for decision-making about stroke prevention in AF.

Opportunities for Improvement

Based on trial data, clinics can:

Define measurable outcomes and set clear goals for using web-based tools for value clarification in AF patients.
Select AI tools that meet specific clinical needs and enhance patient understanding.
Implement projects step-by-step, using AI to track results and impact in real-world scenarios.