Defining clinically important difference in the atrial fibrillation effect on quality-of-life score: Results from the outcomes registry for better informed treatment of atrial fibrillation

Dajuanicia N. Holmes, Jonathan P. Piccini, Larry A. Allen, Gregg C. Fonarow, Bernard J. Gersh, Peter R. Kowey, Emily C. O'Brien, James A. Reiffel, Gerald V. Naccarelli, Michael D. Ezekowitz, Paul S. Chan, Daniel E. Singer, John A. Spertus, Eric D. Peterson, Laine Thomas

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Background: The Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire has recently been validated to measure the impact of atrial fibrillation on quality of life, but a clinically important difference in AFEQT score has not been well defined. Methods and Results: To determine the clinically important difference in overall AFEQT (score range= 0 [worst] to 100 [best]) and selected subscales, we analyzed data in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry, a United States-based outpatient atrial fibrillation registry. AFEQT was assessed at baseline and 1 year in a subset of 1347 ORBIT-AF patients from 80 US sites participating in ORBIT-AF from June 2010 to August 2011. The mean change method was used to relate changes in 1-year AFEQT scores to clinically important changes in the physician assessment of European Heart Rhythm Association functional status (1 class improvement and separately 1 class deterioration). Clinically important differences and 95% CI corresponding to either a 1 European Heart Rhythm Association class improvement or deterioration were 5.4 (3.6-7.2) and-4.2 (-6.9 to-1.5) AFEQT points, respectively. Similarly, clinically important difference values were seen for a 1 European Heart Rhythm Association class improvement for the AFEQT subscales Activities of Daily Living and Symptoms: 5.1 (2.5-7.6) and 7.1 (5.3-9.0) AFEQT points, respectively. Conclusions: Based on the anchor of 1 European Heart Rhythm Association class change, changes in AFEQT score of + or-5 points are clinically important changes in patients' health. Clinical Trial Registration: URL: Unique identifier: NCT01165710.

Original languageEnglish (US)
Article numbere005358
JournalCirculation: Cardiovascular Quality and Outcomes
Issue number5
StatePublished - May 1 2019

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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