Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Jean Potocki : le travail du temps

Jean Potocki s’est suicidé le 23 décembre 1815 dans son domaine d’Uładówka en Ukraine. L’année 2015 a donné lieu à plusieurs manifestations commémoratives : à Łańcut, qui fut le château de la famille Potocki jusqu’en 1944, à Paris, à la Bibliothèque polonaise, à Francfort-sur-l’Oder. Ce fut l’occasion de faire le point sur les découvertes les plus récentes concernant l’écrivain et son œuvre, en particulier un magnifique cahier de dessins réalisés sur les routes espagnoles ; ce fut aussi l’occasion, de l’Espagne à la Russie, de voir apparaître de jeunes chercheurs. La plupart des vingt contributions réunies dans cet ouvrage ont été présentées lors des manifestations de l’année 2015 ; elles ont été réparties en quatre chapitres par les éditeurs : L’homme, L’œuvre, Le Manuscrit trouvé à Saragosse, Documents inédits. Depuis 1958, année de l’apparition de Jean Potocki dans la littérature française, les travaux, les éditions se sont succédé. Le bicentenaire permit à la fois un bilan et une projection : si les progrès ont été considérables depuis la découverte de Roger Caillois, ces progrès laissent aussi deviner les lacunes encore nombreuses dans notre connaissance de l’homme et de son œuvre. Assurément, les bibliothèques et les archives européennes recèlent encore des documents que les futurs chercheurs mettront au jour et qui enrichiront, peut-être redessineront l’œuvre et l’approche critique : c’est précisément le travail du temps

Memorias II congreso internacional de investigación "San Martín Investiga" 2021

El Congreso internacional San Martín Investiga, es un espacio de discusión sobre los avances en el campo de la salud y la educación. Permite a investigadores de distintas nacionalidades dialogar sobre sus avances de investigación. Como espacio abierto, se presentan las memorias del evento en idioma español e inglés para un intercambio abierto con la comunidad académica mundial. Se aclara que la Fundación Universitaria San Martín no se hace responsable por los conceptos emitidos por los investigadores en sus trabajos y que cualquier inquietud puede ser remitida a los autores. The International Research Congress San Martín Investiga is a space for discussion on advances in the field of social science and health science. It allows researchers of different nationalities to discuss their research advances. As an open space, the proceedings of the event are presented in Spanish and English for an open exchange with the world academic community. It is clarified that the Fundación Universitaria San Martin is not responsible for the concepts issued by the researchers in their work and that any concerns can be referred to the authors

PLoS ONE

e014841

The burden of mild asthma: Clinical burden and healthcare resource utilisation in the NOVELTY study

Background: Patients with mild asthma represent a substantial proportion of the population with asthma, yet there are limited data on their true burden of disease. We aimed to describe the clinical and healthcare resource utilisation (HCRU) burden of physician-assessed mild asthma.Methods: Patients with mild asthma were included from the NOVEL observational longiTudinal studY (NOVELTY; NCT02760329), a global, 3-year, real-world prospective study of patients with asthma and/or chronic obstructive pulmonary disease from community practice (specialised and primary care). Diagnosis and severity were based on physician discretion. Clinical burden included physician-reported exacerbations and patient-reported measures. HCRU included inpatient and outpatient visits.Results: Overall, 2004 patients with mild asthma were included; 22.8% experienced ≥1 exacerbation in the previous 12 months, of whom 72.3% experienced ≥1 severe exacerbation. Of 625 exacerbations reported, 48.0% lasted >1 week, 27.7% were preceded by symptomatic worsening lasting >3 days, and 50.1% required oral corticosteroid treatment. Health status was moderately impacted (St George's Respiratory Questionnaire score: 23.5 [standard deviation ± 17.9]). At baseline, 29.7% of patients had asthma symptoms that were not well controlled or very poorly controlled (Asthma Control Test score <20), increasing to 55.6% for those with ≥2 exacerbations in the previous year. In terms of HCRU, at least one unscheduled ambulatory visit for exacerbations was required by 9.5% of patients, including 9.2% requiring ≥1 emergency department visit and 1.1% requiring ≥1 hospital admission.Conclusions: In this global sample representing community practice, a significant proportion of patients with physician-assessed mild asthma had considerable clinical burden and HCRU

Treatable traits in the NOVELTY study

CorrigendumVolume 27, Issue 12, Respirology, pages: 1095-1095. First Published online: November 6, 2022 10.1111/resp.14406International audienceAsthma and chronic obstructive pulmonary disease (COPD) are two prevalent and complex diseases that require personalized management. Although a strategy based on treatable traits (TTs) has been proposed, the prevalence and relationship of TTs to the diagnostic label and disease severity established by the attending physician in a real-world setting are unknown. We assessed how the presence/absence of specific TTs relate to the diagnosis and severity of 'asthma', 'COPD' or 'asthma + COPD'

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

Vitamin K antagonist control in patients with atrial fibrillation in Asia compared with other regions of the world: Real-world data from the GARFIELD-AF registry

Objective: To compare the distribution of international normalized ratios (INRs) in patients receiving vitamin K antagonist (VKA) for newly diagnosed atrial fibrillation in Eastern and Southeastern Asia and in other regions of the world (ORW) represented in the ongoing, global observational study GARFIELD-AF