Defining Clinically Important Difference in the Atrial Fibrillation Effect on Quality-of-Life Score.


Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Holmes, DN; Piccini, JP; Allen, LA; Fonarow, GC; Gersh, BJ; Kowey, PR; O'Brien, EC; Reiffel, JA; Naccarelli, GV; Ezekowitz, MD; Chan, PS; Singer, DE; Spertus, JA; Peterson, ED; Thomas, L

Published Date

  • May 2019

Published In

Volume / Issue

  • 12 / 5

Start / End Page

  • e005358 -

PubMed ID

  • 31092022

Pubmed Central ID

  • 31092022

Electronic International Standard Serial Number (EISSN)

  • 1941-7705

Digital Object Identifier (DOI)

  • 10.1161/CIRCOUTCOMES.118.005358


  • eng

Conference Location

  • United States