Appendix Table 2.

Inclusion and Exclusion Criteria

PICOTS Element	Inclusion Criteria	Exclusion Criteria
Populations	Adults (≥18 years of age) Patients with nonvalvular AF (including atrial flutter): Paroxysmal AF (recurrent episodes that self-terminate in less than 7 days) Persistent AF (recurrent episodes that last more than 7 days until stopped) Permanent AF (continuous) Patients with AF who experience acute coronary syndrome Subgroups of interest for KQ 3 include (but are not limited to): Age Sex Race/ethnicity Presence of heart disease Type of AF Comorbid conditions (such as moderate to severe chronic kidney disease (eGFR<60), dementia) When in therapeutic range When non-adherent to medication Previous thromboembolic event Previous bleed Pregnant	Patients who have known reversible causes of AF (including but not limited to postoperative, hyperthyroidism) All subjects are <18 years of age, or some subjects are under <18 years of age but results are not broken down by age
Interventions	KQ 1: Clinical and imaging tools and associated risk factors for assessment/evaluation of thromboembolic risk: Clinical tools include: CHADS2 score CHADS2-VASc score Framingham risk score ABC stroke risk score Individual risk factors include: INR level Duration and frequency of AF Age Prior stroke Type of AF Cognitive impairment Falls risk Presence of heart disease Presence and severity of CKD DM Sex Race/ethnicity Cancer HIV Imaging tools include: Transthoracic echo (TTE) Transesophageal echo (TEE) CT scans Cardiac MRIs KQ 2: Clinical tools and individual risk factors for assessment/evaluation of intracranial hemorrhage bleeding risk: Clinical tools include: HAS-BLED score HEMORR2HAGES score ATRIA score Bleeding Risk Index ABC Bleeding Risk score Individual risk factors include: INR level Duration and frequency of AF Age Prior stroke Type of AF Cognitive impairment Falls risk Presence of heart disease Presence and severity of CKD DM Sex Race/ethnicity Cancer HIV KQ 3: Anticoagulation, antiplatelet, and procedural interventions: Anticoagulation therapies: VKAs: Warfarin Newer anticoagulants (direct oral anticoagulants [DOACs]) Direct thrombin Inh-DTI: Dabigatran Factor Xa inhibitors: Rivaroxaban Apixaban Edoxaban Antiplatelet therapies: Clopidogrel Aspirin Dipyridamole Combinations of antiplatelets Aspirin+dipyridamole Procedures: Surgeries (e.g., left atrial appendage occlusion, resection/removal) Minimally invasive (e.g., Atriclip, LARIAT) Transcatheter (WATCHMAN™, AMPLATZER™, PLAATO)	None
Comparators	KQ 1: Other clinical or imaging tools listed for assessing thromboembolic risk KQ 2: Other clinical tools listed for assessing bleeding risk KQ 3: Other anticoagulation therapies, antiplatelet therapies, or procedural interventions for preventing thromboembolic events	For KQ 3, studies that did not include an active comparator
Outcomes	Assessment of clinical and imaging tool efficacy for predicting thromboembolic risk and bleeding events (KQs 1 and 2): Diagnostic accuracy efficacy Diagnostic thinking efficacy (defined as how using diagnostic technologies help or confirm the diagnosis of the referring provider) Therapeutic efficacy (defined as how the intended treatment plan compares with the actual treatment pursued before and after the diagnostic examination) Patient outcome efficacy (defined as the change in patient outcomes as a result of the diagnostic examination) Patient-centered outcomes for KQ 3 (and for KQ 1 [thromboembolic outcomes] and KQ 2 [bleeding outcomes] under “Patient outcome efficacy”): Thromboembolic outcomes: Cerebrovascular infarction TIA Systemic embolism (excludes PE and DVT) Bleeding outcomes: Hemorrhagic stroke Intracranial hemorrhage (intracerebral hemorrhage, subdural hematoma) Major and minor bleed (stratified by type and location)a Other clinical outcomes: Mortality All-cause mortality Cardiovascular mortality Myocardial infarction Infection Heart block Esophageal fistula Cardiac tamponade Dyspepsia Health-related quality of life Functional capacity Health services utilization (e.g., hospital admissions, outpatient office visits, ER visits, prescription drug use) Long-term adherence to therapy Cognitive function	Study does not include any outcomes of interest
Timing	Timing of followup not limited	None
Setting	Inpatient and outpatient	Studies which were conducted exclusively in Asia, Africa, or the Middle Eastb
Study design	Original peer-reviewed data N ≥20 patients RCTs, prospective and retrospective observational studies	Not a clinical study (e.g., editorial, nonsystematic review, letter to the editor, case series, case reports) Abstract-only or poster publications; articles that have been retracted or withdrawn Because studies with fewer than 20 subjects are often pilot studies or studies of lower quality,110,111 we excluded them from our review Systematic reviews, meta-analyses, or methods articles (used for background and component references only) Observational studies that are only relevant to KQ 3 (treatment), have fewer than 1000 patients, and only target pharmacological interventionsc
Publications	English-language publications Published on or after January 1, 2000	Non–English-language publicationsd Relevant systematic reviews, meta-analyses, or methods articles (will be used for background only)