| Evidence-Based Medicine Case 3 |
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Taylor and colleagues carried out a systematic review to examine the benefits and risks of long term anticoagulation (warfarin) compared with antiplatelet treatment (aspirin/indoprofen) in patients with non-rheumatic atrial fibrillation. (See this paper as: Taylor et al. Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation. Br Med J 2001, 322:321–326). A. Why did the authors include only randomized controlled trials in their systematic review of the selected topic? B. The authors report that the overall odds ratio for fatal vascular outcomes (myocardial infarction and/or thromboembolism) was 0.86 (95% CI 0.63–1.17) for anticoagulation versus antiplatelet treatment (figure). Is this effect “statistical significant”? C. If you had a patient with heart valve replacement, could you ap-ply the results of this review for the management of his/her atrial fibrillation with either anticoagulation or antiplatelet treatment?
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