Atrial fibrillation is an important risk factor for stroke. Anticoagulant treatment reduces the risk substantially but may also lead to haemorrhagic complications. The recommended approach is to balance the risk of stroke against the risk of bleeding when making decisions on anticoagulant treatment or not. It remains challenging for medical doctors to keep track of how stroke risk changes over time in atrial fibrillation patients.
The overall aim of the project is to identify targets and tools for better stroke prevention in atrial fibrillation patients. Based on anonymously compiled health information from national registries, we will assess individual risk of stroke in patients with atrial fibrillation dynamically over time, as risk changes with increasing age and comorbidity. We will assess whether certain characteristics of patient pathways may lead to hospital admission for stroke in atrial fibrillation patients. Further, we will investigate whether there are differences in the use of health services for different groups of patients with atrial fibrillation, in order to identify groups that may need more targeted preventive measures. Finally, we will investigate whether a registry-based tool for stroke risk has the potential to guide and improve clinical decisions for stroke prevention in patients with atrial fibrillation.
The project is a collaboration between researchers in epidemiology, statistics and health economics and collaborators that will make use of the gained knowledge, from patient organizations to general practitioners. A long-term goal of the project is to contribute to innovative registry-based tools that can be used as decision support by general practitioners within the framework of existing electronic patient records. We also aim to explore whether patients themselves can benefit from access to such information.
Atrial fibrillation (AF) is an important risk factor for stroke. Anticoagulant treatment reduces the risk substantially but may also lead to haemorrhagic complications. The recommended approach is to balance the risk of stroke against the risk of bleeding. It remains a clinical challenge to keep track of temporal changes in stroke risk in AF patients and decide for anticoagulant treatment or not. Recent registry data have indicated stable rates of ischemic stroke in atrial fibrillation patients, while rates of haemorrhagic strokes are increasing. There is an urgent need to establish more targeted and tailored preventive measures within the primary and secondary healthcare services.
Based on a novel clinical application of data-driven methods from real-life registry data, the project has the ambition identify targets and tools for more efficient, precise and personalized stroke prevention in AF patients. The current project will study clinical patterns of risk factors and treatment preceding hospitalizations for acute stroke in AF patients to identify potential action points to improve decision-making for stroke prevention. We will further explore any disparity in health care follow up of AF patients to identify groups in need of more targeted preventive measures. Finally, the project will investigate whether a dynamic, personalized register-based stroke risk scoring tool can guide and improve clinical decision-making for stroke prevention in atrial fibrillation patients.
Using an interdisciplinary approach, the project combines research traditions from epidemiology, biostatistics, health economics, and social medicine, and include user expertise from clinical specialist medicine, clinical general practice, interaction across sectors of care, quality tool development in general practice, in addition to technological solutions for innovation and development of primary care electronic medical records.
BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering