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[Agency] NIH [Project Title] CONTEMPORARY TREATMENT AND OUTCOMES FOR ATRIAL FIBRILLATION IN CLINICAL PRACTICE [Institution] KAISER FOUNDATION RESEARCH INSTITUTE [Amount] $40,390 [Summary] Aim 1: Develop and test novel risk stratification schemes for thromboembolism (ischemic stroke and systemic thromboembolism) in patients with atrial fibrillation from a large-scale community-based cohort and additionally validate the resulting risk models against rich datasets from randomized clinical trials in atrial fibrillation. Aim 2: Establish and characterize a contemporary registry of incident atrial fibrillation within very large, diverse community-based populations to provide critical insights into current outcome event rates and practice patterns, potential health disparities, and to facilitate more rapid enrollment into future effectiveness studies and clinical trials as well as development of improved risk stratification models. Aim 3: Identify and validate optimal design and analytic approaches to reduce confounding and bias for comparative effectiveness analyses (e.g., different antithrombotic strategies) in observational studies of patients with atrial fibrillation. PUBLIC HEALTH RELEVANCE: Atrial fibrillation is the most common clinically significant arrhythmia in adults and one of the most potent risk factors for ischemic stroke and other systemic throm-boembolism. It currently affects millions of Americans and its prevalence is expected to increase substantially during the next several decades. While multiple strategies have been developed to reduce the risks of atrial fibrillation-related adverse events, existing risk stratification schemes are of limited clinical utility in guiding treatment decisions. Furthermore, few data exist about the comparative effectiveness of different therapies in clinical practice. The proposed study will provide a critical set of research resources to improve risk prediction, facilitate more valid comparative effectiveness analyses, and streamline the planning and conduct of future randomized clinical trials in atrial fibrillation. [Link] link [Category] 
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