Inconsistent Methodology as a Barrier to Meaningful Research Outputs From Studies of Atrial Fibrillation After Cardiac Surgery.

Campbell, Niall G ORCID: 0000-0003-4269-3848, Wollborn, Jakob ORCID: 0000-0002-6767-7978, Fields, Kara G, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Ruetzler, Kurt ORCID: 0000-0003-0467-1736, Muehlschlegel, Jochen D and O'Brien, Benjamin ORCID: 0000-0001-7024-2337
(2022) Inconsistent Methodology as a Barrier to Meaningful Research Outputs From Studies of Atrial Fibrillation After Cardiac Surgery. Journal of cardiothoracic and vascular anesthesia, 36 (3). pp. 739-745.

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Atrial fibrillation after cardiac surgery (AFACS) is a serious postoperative complication. There is significant research interest in this field but also relevant heterogeneity in reported AFACS definitions and approaches used for its identification. Few data exist on the extent of this variation in clinical studies. The authors reviewed the literature since 2001 and included manuscripts reporting outcomes of AFACS in adults. They excluded smaller studies and studies in which patients did not undergo a sternotomy. The documented protocol in each manuscript was analyzed according to six different categories to determine how AFACS was defined, which techniques were used to identify it, and the inclusion and/or exclusion criteria. They also noted when a category was not described in the documented protocol. The authors identified 302 studies, of which 92 were included. Sixty-two percent of studies were randomized controlled trials. There was significant heterogeneity in the manuscripts, including the exclusion of patients with preoperative AF, the definition and duration of AF needed to meet the primary endpoint, the type of screening approach (continuous, episodic, or opportunistic), the duration of monitoring during the study period in days, the diagnosis with predefined electrocardiogram criteria, and the requirement for independent confirmation by study investigators. Furthermore, the definitions of these criteria frequently were not described. Consistent reporting standards for AFACS research are needed to advance scientific progress in the field. The authors here propose pragmatic standards for trial design and reporting standards. These include adequate sample size estimation, a clear definition of the AFACS endpoints, and a protocol for AFACS detection.

Item Type: Article
Uncontrolled Keywords: Humans, Atrial Fibrillation, Postoperative Complications, Electrocardiography, Cardiac Surgical Procedures, Adult, Randomized Controlled Trials as Topic
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 11 Oct 2023 14:33
Last Modified: 11 Oct 2023 14:33
DOI: 10.1053/j.jvca.2021.10.009
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