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Article summary:
1. The RE-LY trial demonstrated that higher-risk patients with atrial fibrillation had lower rates of stroke or systemic embolism and a similar rate of major bleeding, on average, when treated with dabigatran 150mg compared to warfarin.
2. Multivariable models were developed to predict the risk for stroke or systemic embolism and for major bleeding including all three treatment groups (dabigatran 110mg, dabigatran 150mg, and warfarin).
3. There is substantial heterogeneity in the benefits and risks of dabigatran relative to warfarin among patients with atrial fibrillation.
Article analysis:
The article is generally trustworthy and reliable as it provides evidence from a randomized controlled trial (RE-LY) which demonstrates that higher-risk patients with atrial fibrillation had lower rates of stroke or systemic embolism and a similar rate of major bleeding, on average, when treated with dabigatran 150mg compared to warfarin. The authors also developed multivariable models to predict the risk for stroke or systemic embolism and for major bleeding including all three treatment groups (dabigatran 110mg, dabigatran 150mg, and warfarin). However, there are some potential biases in the article such as one-sided reporting as only positive results from the RE-LY trial are reported without any mention of negative results. Additionally, there is missing evidence for some claims made in the article such as the claim that individualized estimates may enable shared decision making and facilitate more appropriate use of dabigatran which is not supported by any evidence. Furthermore, there is no exploration of counterarguments which could be used to challenge the findings presented in the article. In addition, there is no mention of possible risks associated with using dabigatran which should have been noted in order to provide a balanced view on its use. All these points should have been considered in order to make sure that both sides are presented equally in order to ensure trustworthiness and reliability of the article.