title: Wearables, Smartphones and Novel Anticoagulants: We Will Treat More Atrial Fibrillation, but Will Patients Be Better Off?
abstract: The widespread adoption of medical practices without a firm evidence base is common and the current growing enthusiasm for atrial fibrillation screening offers a real-time example of this phenomenon. Although no randomized trials supporting the utility of screening for atrial fibrillation exist, proponents suggest that such screening should be considered. Atrial fibrillation is a common condition that is often asymptomatic. It is also a condition associated with serious morbidity, primarily resulting from stroke. We practice at a time in which the ability to detect atrial fibrillation is becoming easier and treatments are becoming less onerous. Screening for atrial fibrillation may be beneficial but there is also a reasonable likelihood that its harms will outweigh it benefits. In this article we make the case that adopting this practice prior to data from randomized controlled trial would be a mistake. If screening for atrial fibrillation is adopted without such a robust evidence base we may well later discover that this course of action was wrong.
authors.affiliation: Section of General Medicine, Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC3051, Chicago, IL, 60637, USA. adamcifu@uchicago.edu.
authors.forename: Adam
authors.initials: A
authors.lastname: Cifu
authors.affiliation: Division of Hematology Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.|Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA.|Center for Health Care Ethics, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Prasad
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic / Q000295:instrumentation / Q000379:methods; D000068997:Smartphone / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D000076251:Wearable Electronic Devices / Q000706:statistics & numerical data*
chemical_list: D000925:Anticoagulants
keywords: anticoagulation; atrial fibrillation; medical decision making; medical reversal