Arrhythmias & electrophysiologyRandomised controlled trial
Effectiveness of shared decision making strategies for stroke prevention among patients with atrial fibrillation: cluster randomized controlled trial
- Cluster randomised controlled trial
- multicentre (6 US academic medical centres)
- factorial
Authors' conclusion
Patients who received any decision aid (encounter decision aid, patient decision aid, or both) had lower decisional conflict, better shared decision making, and greater knowledge than those receiving no decision aid, except for the effect of the patient decision aid on decisional conflict, which did not reach statistical significance.
Study context
- Population
- Adults with non-valvular AF at risk for stroke (CHA2DS2-VASc ≥1 men, ≥2 women) scheduled to discuss stroke prevention, and their clinicians
- Participants
- 1,117 adults · 6 sites
- Comparison
- Patient decision aid and/or encounter decision aid vs usual care
- Primary endpoint
- Quality of shared decision making (OPTION12), knowledge of AF and its management, and decisional conflict
Primary result
As reported in the abstract
Both decision aids vs Usual careAdjusted mean difference (95% CI)P value
quality of shared decision making (OPTION12)
12.1(8.0–16.2)
P < 0.001decisional conflict
−6.3(−9.6 to −3.1)
P < 0.001Both decision aids vs Usual careOdds ratio (95% CI)P value
patients' knowledge
1.68(1.35–2.09)
P < 0.001Further findings
Treatment choices for stroke prevention, participants' satisfaction
- No important differences
Length of visit
- No statistically significant difference across study groups
Original publication
Effectiveness of shared decision making strategies for stroke prevention among patients with atrial fibrillation: cluster randomized controlled trial. BMJ. Published 9 January 2025. doi:10.1136/bmj-2024-079976
Summarised from the published abstract; every number is checked against it