Rigorous Bivariate Synthesis of Benefit-Risk Profiles for Direct Oral Anticoagulants in Atrial Fibrillation

Authors

  • Oluwatomi Olukoya GMC
  • Khaing Mar Lwin
  • Ata Ul Hayee Sohail

Abstract

Selection of anticoagulant therapy relies on a balance between ischemic stroke prevention (the benefit) and (the risk) of major bleeding.[1] This analysis highlights a bivariate random effect meta-analysis of the four key Phase III trials. Making a comparison of Direct Oral Anticoagulant (DOACs) versus warfarin drawing on the four key Phase III trials:RE-LY, ROCKET-AF, ARISTOTLE, and ENGAGE AF-TIMI 48. This is done by incorporating modern small sample adjustments and conformal prediction intervals, in order to provide a strengthened framework for evidence based decision making under uncertainty.

References

1. Hartung, J., & Knapp, G. (2001). A refined method for the meta-analysis of controlled clinical trials with binary outcome.2Statistics in Medicine, 20(24), 3875-3889.

2. Riley, R. D., et al. (2017). Multivariate and network meta-analysis of multiple outcomes and multiple treatments: rationale, concepts, and examples.3 BMJ, 358, j3932.

3. Viechtbauer, W. (2005). Bias and efficiency of meta-analytic variance estimators in the random-effects model.4 Journal of Educational and Behavioral Statistics, 30(3), 261-293.

4. Vovk, V., Gammerman, A., & Shafer, G. (2005). Algorithmic Learning in a Random World.5 Springer Science & Business Media.

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Published

2026-04-12 — Updated on 2026-06-15

Versions

Issue

Vol. 1 No. 1 (2025): Cardiology

Section

E156 Research Letter

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Copyright (c) 2025 Oluwatomi Olukoya, Khaing Mar Lwin, Ata Ul Hayee Sohail

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Articles in Synthēsis are published under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Authors retain copyright.

How to Cite

Rigorous Bivariate Synthesis of Benefit-Risk Profiles for Direct Oral Anticoagulants in Atrial Fibrillation. (2026). Synthēsis, 1(1). https://synthesis-medicine.org/index.php/journal/article/view/12 (Original work published 2026)

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