Perceptions and knowledge gaps on CHA2DS2-VASc score components: a joint survey of Chinese clinicians and clinical pharmacists

Background The CHA(2)DS(2)-VASc score is a guideline-recommended stroke risk stratification scheme for patients with atrial fibrillation (AF). Accurately calculating the CHA(2)DS(2)-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 CHA(2)DS(2)-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 CHA(2)DS(2)-VASc score. In general, cardiologists, neurologists, and CPs had a relatively better understanding than GPs and EPs about the application of CHA(2)DS(2)-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,' 'A(2),' 'S-2,' 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 CHA(2)DS(2)-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 CHA(2)DS(2)-VASc scores and their components. Improvements in the awareness of the CHA(2)DS(2)-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.

Automated summary

Chinese medical professionals, especially EPs and GPs, lack knowledge and skills in CHA(2)DS(2)-VASc scores and their components. There is an urgent need to improve awareness of the CHA(2)DS(2)-VASc score and its detailed scoring criteria for Chinese medical professionals. Education programs introducing stroke risk evaluation for AF patients and developing referencing scoring tools are necessary.