1. What is the AnticoagEvaluator?
  2. What's new in the updated version of the AnticoagEvaluator?
  3. How can I access the AnticoagEvaluator?
  4. How is the AnticoagEvaluator intended to be used?
  5. Where did the information and recommendations in the App come from?
  6. How was the App developed and tested?
  7. Are there plans to further update the AnticoagEvaluator?
  8. How can I provide feedback on the app and how will it be used?
  9. Who is the intended audience for the app?
  10. Will patients benefit from the app?
  11. Will any personal or patient information be collected by the App?
  12. How does the ACC AnticoagEvaluator relate to the other ACC tools, products, and programs?
  13. What is the relationship of the AnticoagEvaluator to other societies and organizations?
  14. Are there any plans to link outputs from the app to EMRs?
  15. Where can I get help and support with using the app?

1. What is the AnticoagEvaluator?

The AnticoagEvaluator is a web and mobile app that helps clinicians make informed decisions on antithrombotic therapy for their non-valvular AF patients. The App was originally released in 2013 and extensively updated in 2015.

Clinicians can use the App to:

  • Calculate a patient's stroke risk (CHA2DS2-VASc), bleed risk (HAS-BLED and concomitant meds), and renal function (Cockcroft-Gault Equation)
  • Review stroke prevention therapy guidance based on ACC/AHA/HRS's 2014 Guidelines for the Management of Patients with Atrial Fibrillation
  • Improve accurate use of DOACs with adjusted dosage based on prescribing information, fine-tuned for renal and other patient characteristics.
  • Determine appropriate therapy for a patient by reviewing
    • Synthesized individualized risk for antithrombotic therapy options based on clinical trials (e.g., ACTIVE-A, RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF)
    • Relevant safety information and full prescribing information for all therapy options

2. What's new in the updated version of the AnticoagEvaluator?

  • The App now incorporates recommendations from the ACC/AHA/HRS Atrial Fibrillation Guideline for anticoagulation based on stroke risk using the CHA2DS2-VASc score
  • Following FDA approval, Edoxaban was added to the list of available anticoagulant therapy options
  • The App now includes the Cockcroft-Gault Equation to calculate creatinine clearance, and provides renal-function-adjusted dosing from the prescribing information for all the direct oral anticoagulants
  • The overall App has been updated with a smoother look and feel based on user feedback
  • The app is now available on the web as well as Apple and Android devices

3. How can I access the AnticoagEvaluator?

The AnticoagEvaluator is free for both ACC members and non-members.

  • If you already have previously downloaded AnticoagEvaluator before December 2015:
    • iPhone and iPad users - Simply accept the latest update to the AnticoagEvaluator on your device to upgrade to the new version
    • Android users – You will need to delete the old version from your device and download the new version from the GooglePlay app store
  • If you are new to the AnticoagEvaluator:
    • To download on a mobile device (Apple or Android), search "AnticoagEvaluator" in the iTunes or GooglePlay app stores.
    • The access on the web, go to: tools.acc.org/AnticoagEvaluator

4. How is the AnticoagEvaluator intended to be used?

The AnticoagEvaluator is intended to help clinicians make informed decisions on antithrombotic therapy for their non-valvular AF patients. Clinicians can use this tool to calculate a patient's risk of ischemic stroke, thromboembolism, and bleed; evaluate renal function; review Guideline-driven therapy guidance for stroke prevention; generate individualized risk for antithrombotic therapy options based on individual clinical trials, and improve accurate use of DOACs with adjusted dosage based on prescribing information, fine-tuned for renal and other patient characteristics.

The information and recommendations in the App are meant to support clinical decision making. They are not meant to represent the only or best course of care, or replace clinical judgment. Therapeutic options should be determined after discussion between the patient and their care provider. The App is also meant to be used in regards to non-valvular Afib patients only. The data and recommendations in the App do not cover Afib patients with mechanical heart valves. Lastly, while the App provides data for the different anticoagulation therapy options based on clinical trials in combination with individual risk factors, this data is not the result of head-to-head trials, and cannot and should not be used to compare safety and efficacy across drugs.

5. Where did the information and recommendations in the App come from?

Therapy guidance is derived from the ACC/AHA/HRS Guideline on the Management of Patients with Atrial Fibrillation. Dosing recommendations come from the prescribing information for each individual medication. Risk/benefit information was adapted from a web tool created by Peter Loewen, BSc(Pharm), ACPR, PharmD, FCSHP, which can be viewed at http://www.sparctool.com/. Individual references for the calculators within the App can be found within the "Resources" section of the App.

6. How was the App developed and tested?

The update of this app was driven and validated by the ACC's Anticoagulation Workgroup, whose hard work is invaluable to the overall Anticoagulation Initiative. Their dedication to improved patient care is reflected in this newly updated point-of-care tool; we are grateful for the time and effort they generously contributed to bring this tool forward.

The original AnticoagEvaluator App and the current update were developed as part of ACC's Anticoagulation Initiative, under the guidance of the Initiative's member work group and ACC's Best Practice and Quality Improvement Subcommittee. The App was further refined and vetted through the oversite of the ACC's Best Practice and Quality Improvement Subcommittee, as well as review and user testing by physicians, nurse practitioners, pharmacists, and other relevant specialists.

Financial support for the app was provided by Daiichi Sankyo, Inc. All content was independently developed with no sponsor involvement.

7. Are there plans to further update the AnticoagEvaluator?

Mobile tools and apps have the great advantage of being quickly and easily disseminated in care settings and able to gather robust and diverse feedback on the app's performance and utility in those settings. When new studies are published and new therapies become available, the ACC will continually update and improve all its apps and other clinical tools to ensure accuracy and utility.

8. How can I provide feedback on the app and how will it be used?

You can provide thoughts, feedback, and suggestions on the AnticoagEvaluator in two ways:

  • Fill out ACC's official feedback survey here. You can access the survey through the "About the App" with the App.
  • Leave comments on the iTunes of Google Play page for the app.

ACC is also collecting data on the App through a variety of additional mechanisms – analytics, usability studies and an impact study. ACC hopes to translate comments into future updates to the App.

9.Who is the intended audience for the app?

The app is targeted to clinicians who care for patients with non-valvular atrial fibrillation. It is not intended for use with AF patients who have mechanical heart valves. It is also not directly intended for patient use.

10. Will patients benefit from the app?

The app is attended to be used clinicians as part of clinical practice. However, it is freely available to all users, including patients.

11. Will any personal or patient information be collected from the app?

No patient information is collected and stored in the app. Anonymous user behavior (e.g., number of people who downloaded the app, how many times a day the app was used) will be gathered through Google Analytics.

12. How does the ACC AnticoagEvaluator relate to the other ACC tools, products, and programs?

The AnticoagEvaluator app is a product of ACC's Anticoagulation Initiative, a multidisciplinary effort that addresses gaps in knowledge in order to develop processes and tools aimed at meeting guideline-recommended standards and improving quality of anticoagulation care. It is also part of the ACC's growing Clinical Mobile App Collection, all designed to be used "on the go" to help optimize patient care. More information about ACC's Clinical App Collection can be found here.

13. What is the relationship of the AnticoagEvaluator to other societies and organizations?

The therapy guidance in the app is derived from ACC/AHA/HRS's joint 2014 Guidelines for the Management of Patients with Atrial Fibrillation.

14. Are there any plans to link outputs from the app to EMRs?

EMR capabilities are not currently built into this version of the AnticoagEvaluator. However, the App does provide the capability to email the results of individual sessions within the app, which can then be transferred into EMR notes. ACC is also piloting EHR integration for some of our other clinical apps, and hope to eventually make this a standard feature of our mobile clinical tools.

15. Where can I get help and support with using the app?

Contact the ACC at 1-800-253-4636 or resource@ACC.org.