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Comment & Response
December 10, 2014

Stroke Risk Following Perioperative Atrial Fibrillation

Author Affiliations
  • 1Department of Surgery, Columbia University, New York, New York
JAMA. 2014;312(22):2410. doi:10.1001/jama.2014.14490

To the Editor The study by Dr Gialdini and colleagues1 evaluated the long-term risk of ischemic stroke in patients with perioperative atrial fibrillation (AF). There is a methodological issue that arises with the use of administrative data to draw clinical inferences.

According to the sensitivity (88%) and specificity (86%) of the diagnosis codes given in the text, as well as the prevalence of AF of 1.43%, the positive predictive value of a diagnosis of perioperative AF in this study would only be 8.4%. In other words, a patient would be much more likely not to have the syndrome than to have it.

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