A freely available tool for use during the consultation between clinicians and their patients with atrial fibrillation considering preventing strokes using anticoagulation.
SDM tool design
This paper describes the process used to design Anticoagulation Choice as an encounter-based SDM tool:
Current version of the tool: http://anticoagulationdecisionaid.mayoclinic.org
Video demonstration of tools use
SDM4AFIB
A practice-based randomized trial of Anticoagulation Choice vs. usual care
- Trial protocol
- Trial registration
- Normalization in practice of Anticoagulation Choice in preparation for the clinical trial
- Trial results – decisional outcomes
- Trial results – clinical outcomes (including adherence)
Note:
In Table 1, for the SNS Inadequate numeracy score the correct count of patients in the intervention arm is 141 (reported 140) out of 448 and for the standard care arm the value of 136 is correct out of 435 encounters.
For Table 2, the following counts were mistakenly omitted. For the clinician type, 4 clinicians were RN out of the 222 clinicians that reported type. For practice type, 26 of the 222 clinician responses were Other (Emergency room, hospitalist, Anticoagulation Clinic, geriatrics, vascular medicine, etc.)
We regret these mistakes introduced in the publication phase.
This work was funded by grant RO1 HL131535-01 from the National Heart, Lung, and Blood Institute of the National Institutes of Health.
SODA-AF
Scan & Optimization of Decision Aids for Atrial Fibrillation
As part of the formative work towards comparing an encounter SDM tool to a patient decision aid for the same decision, the KER Unit conducted an environmental scan and stakeholder interviews to determine the characteristics that these two forms of decision support should have, and should have in common. This is project funded by a grant to University of Utah and Mayo Clinic through a funding collaboration between American Heart Association and the Patient-Centered Outcomes Research Institute (PCORI) Grant # 18SFRN34110489 to Dr Fagerlin (Center, STEP-UP AF), and Grant # 18SFRN34230142 to Dr Ozanne/(Project, RED-AF).
Report on the environmental scan (PDF) and expert panel review document and minutes as well as patient interviews.
Publication of the SODA-AF project: Torres Roldan VD, Brand-McCarthy SR, Ponce OJ, Belluzzo T, Urtecho M, Espinoza Suarez NR, Toloza FJK, Thota AD, Organick PW, Barrera F, Liu-Sanchez C, Jaladi S, Prokop L, Ozanne EM, Fagerlin A, Hargraves IG, Noseworthy PA, Montori VM, Brito JP. Shared Decision Making Tools for People Facing Stroke Prevention Strategies in Atrial Fibrillation: A Systematic Review and Environmental Scan. Med Decis Making. 2021 Jul;41(5):540-549. doi: 10.1177/0272989X211005655. Epub 2021 Apr 24. PMID: 33896270; PMCID: PMC8191170. (PDF)
Protocol of the randomized trial testing encounter SDM vs. patient decision aid (RED-AF trial): Jones AE, McCarty MM, Brito JP, Noseworthy PA, Cavanaugh KL, Cameron KA, Barnes GD, Steinberg BA, Witt DM, Crossley GH, Passman R, Kansal P, Hargraves I, Schmidt M, Jackson E, Guzman A, Ariotti A, Pershing ML, Herrick J, Montori VM, Fagerlin A, Ozanne EM; STEP-UP AFIB Writing Group. Randomized evaluation of decision support interventions for atrial fibrillation: Rationale and design of the RED-AF study. Am Heart J. 2022 Jun;248:42-52. doi: 10.1016/j.ahj.2022.02.010. Epub 2022 Feb 24. PMID: 35218727. (PDF)
DISCLAIMER: No SDM tool replaces the conversation patients should have with their clinicians to make important, clinical decisions. Use of these SDM tools carries no liability to its developers or to the Mayo Clinic Foundation for Education and Research.
Feedback
If you download our SDM tools, we would love to hear from you! Please send us a note at kerunit@mayo.edu to let us know who you are, why you are interested in the SDM tool(s), and how you plan to use them. Remember to check back to this page periodically to make sure you are using the most up-to-date version(s).