A newly-published study featuring several DPHS authors has aimed to quantify patients’ preferences for health outcomes associated with atrial fibrillation (AF) to better shed light on what events they considered to be the most serious.
The PEARL-AF study, which included DPHS authors Shelby Reed, Jui-Chen Yang, Matthew Wallace, and Juan Marcos González Sepúlveda, involved a preference survey to estimate the relative importance of AF-related events for use in clinical trial analyses to estimate net health benefits with anticoagulants. 1028 participants were given patient-friendly descriptions of three severities of stroke, systemic embolism, myocardial infarction (MI) with or without subsequent heart failure (HF), major bleeding, clinically relevant nonmajor bleeding, and death, and then asked to select what they considered to be most and least serious.
Results showed death was considered the most serious, followed by severe disabling stroke, major bleeding or MI with HF, moderate-severity stroke, and systemic embolism. Clinically relevant nonmajor bleeding, MI without HF, and minor stroke were considered least serious. Currently, moderate-severity stroke or systemic embolism are endpoints frequently used in AF trials, yet the PEARL-AF results show patients have high levels of concern about major bleeding events. These estimated weights could be used in the future for patient-centered net-benefit determinations for AF therapies.