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Perceptions and knowledge gaps on CHA2DS2-VASc score components: a joint survey of Chinese clinicians and clinical
Chi Zhang1,2,3, Long Shen4, Mang-Mang Pan2
1School of Medicine, Tongji University, Shanghai 200092, China.
Insights
Chinese medical professionals, particularly emergency physicians and general practitioners, show knowledge gaps in applying the CHA2DS2-VASc score for atrial fibrillation stroke risk. Targeted education programs are needed to improve understanding and application of this crucial stroke risk stratification tool.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- The CHA2DS2-VASc score is essential for stratifying stroke risk in atrial fibrillation (AF) patients.
- Accurate stroke risk assessment is fundamental for effective anticoagulation therapy in AF.
- Understanding healthcare professionals' knowledge of the CHA2DS2-VASc score is vital for improving patient care.
Purpose of the Study:
- To assess the knowledge and perceptions of Chinese medical professionals regarding the CHA2DS2-VASc score.
- To identify specific knowledge gaps in the application and components of the CHA2DS2-VASc score.
- To inform the development of targeted educational interventions for improving stroke risk assessment in AF patients.
Main Methods:
- A cross-sectional survey was administered to various medical specialists in mainland China.
- A 21-question online questionnaire assessed knowledge of the CHA2DS2-VASc score and its components.
- Participants included cardiologists, neurologists, emergency physicians, general practitioners, and clinical pharmacists.
Main Results:
- Over 560 professionals participated, with most reporting a need for improved CHA2DS2-VASc score skills.
- Cardiologists, neurologists, and clinical pharmacists demonstrated better understanding than emergency physicians and general practitioners.
- While 'H' and 'D' components were well-understood, detailed scoring criteria and other components ('C,' 'A2,' 'S2,' 'V') showed lower correctness rates.
Conclusions:
- Significant knowledge deficits regarding the CHA2DS2-VASc score exist among Chinese medical professionals, especially EPs and GPs.
- Enhanced awareness and understanding of detailed scoring criteria for the CHA2DS2-VASc score are urgently required.
- Educational programs and accessible referencing tools are necessary to improve stroke risk evaluation for AF patients.
Background:
The CHA2DS2-VASc score is a guideline-recommended stroke risk stratification scheme for patients with atrial fibrillation (AF). Accurately calculating the CHA2DS2-VASc score and recognizing the stroke risk in AF patients is the foundation of optimal anticoagulation therapy. This survey aims to obtain a comprehensive understanding of perceptions and knowledge gaps on CHA2DS2-VASc scores among Chinese medical professionals for future education programs.
Methods:
A cross-sectional survey was conducted among clinicians, including cardiologists, neurologists, emergency physicians (EPs), general practitioners (GPs) and clinical pharmacists (CPs) using a self-administered questionnaire on the Chinese mainland. The survey contained 21 questions in combination with single-choice questions, multiple-choice questions, and an open-ended question, which was distributed online via e-mail or social media.
Results:
A total of 562 participants (40.9% cardiologists, 19.2% neurologists, 8.5% EPs, 10.3% GPs, and 21.0% CPs) completed the survey. Most respondents across all specialties reported skills requiring improvements in the CHA2DS2-VASc score. In general, cardiologists, neurologists, and CPs had a relatively better understanding than GPs and EPs about the application of CHA2DS2-VASc score. Considering 'H' and 'D' components, more than 90% of respondents chose the correct answer in single-choice questions, whereas the correctness rate declined concerning detailed scoring criteria. Regarding 'C,' 'A2,' 'S2,' and 'V' components, partly correct answers were commonly observed in most multiple-choice questions. The majority of cardiologists believed themselves to be very familiar or at least familiar with the score and its components, while around 70% of EPs and GPs felt relatively unfamiliar with the CHA2DS2-VASc score. Mobile apps, AF guidelines and notebooks/handbooks were popular referencing scoring tools for respondents.
Conclusions:
Chinese medical professionals, especially EPs and GPs, revealed a lack of knowledge and insufficient skills for CHA2DS2-VASc scores and their components. Improvements in the awareness of the CHA2DS2-VASc score and its detailed scoring criteria are urgently needed for Chinese medical professionals. Therefore, education programs concerning the introduction of stroke risk evaluation for AF patients and the development of referencing scoring tools are necessary.
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