Reducing age bias in decision analyses of anticoagulation for patients with nonvalvular atrial fibrillation - A microsimulation study.

ABSTRACT:

Background

Anticoagulation decreases a patient's risk of ischemic stroke and increases the risk of hemorrhage. Decision analyses regarding anticoagulation therefore require that different outcomes be weighted in comparison to one another. Most decision analyses to date have weighted intracranial hemorrhage (ICH) as 1.5 times worse than ischemic stroke, but because death and disability have lifelong impact, the expected impact should vary by life expectancy. Therefore, a fixed weighting ratio leads to age-related bias decision analyses of anticoagulation. We aimed to quantify the relative impact of ICH and ischemic stroke and derive a ratio that allows decision analysis without microsimulation.

Methods

We created a microsimulation model to predict QALYs lost due to ICH and is

SUBMITTER: Pappas MA 

PROVIDER: S-EPMC6040745 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature