Researchers used real-world clinical data to attempt to emulate a randomized controlled trial testing the effectiveness of two blood thinners, apixaban and warfarin, to prevent stroke in patients with non-valvular atrial fibrillation.
The study provides a method to explore the effects of treatments in patients who are underrepresented or excluded from clinical trials.
Patients experiencing atrial fibrillation -- a potentially dangerous medical condition in which the upper chambers of the heart beat irregularly -- will often be prescribed blood thinners such as apixaban or warfarin to prevent a stroke. However, these treatment recommendations are based on results from randomized controlled trials, and it is unknown if they are applicable to populations of patients who were not included in the trial or present only in very low numbers.
The authors add,"Our study aimed to emulate a reference trial in oral anticoagulants in patients with atrial fibrillation using routinely collected UK healthcare data. Reference-trial informed design provides a framework for the study of treatment effects in patient groups excluded from or under-represented in trials."Emma Maud Powell, Usha Gungabissoon, John Tazare, Liam Smeeth, Paris J. Baptiste, Turki M. Bin Hammad, Angel Y. S. Wong, Ian J. Douglas, Kevin Wing.
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