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SPARCtool Updated

version 6.21 release notes

SPARCmobile

• updated the disclaimer
• fixed truncated renal dysfunction warning for new OACs on iPhone and increased visibility of warnings.
• changed text of the warnings to “RENAL FUNCTION WARNING: Consult product monograph.” - dosage adjustment thresholds and stragtegies are evolving, so no specific advice is offered in the SPARCtool.
• lightened most of the fill colors
• updated dabigatran 150mg thromboembolism risk with updated RE-LY data (updated RR 0.66 −-> 0.65, RRR vs. warfarin from 78% to 79%) [Connolly SJ, Ezekowitz MD, Yusuf S, Reilly PA, Wallentin L. Newly Identified Events in the RE-LY Trial. N Engl J Med 2010;363:1875–6.]
• corrected major bleeding risk of ASA+clopidogrel to be the same as warfarin based on ACTIVE-W.
• added tabular view of the risks

SPARCtool

• updated the disclaimer
• changed text of the warnings to "WARNING: may be contraindicated or require dosage reduction depending on degree of renal dysfunction. Consult your country's monograph."
• dosage adjustment thresholds and stragtegies are evolving, so no specific advice is offered in the SPARCtool.
• lightened most of the fill colors
• updated dabigatran 150mg thromboembolism risk with updated RE-LY data (updated RR 0.66 −-> 0.65, RRR vs. warfarin from 78% to 79%) [Connolly SJ, Ezekowitz MD, Yusuf S, Reilly PA, Wallentin L. Newly Identified Events in the RE-LY Trial. N Engl J Med 2010;363:1875–6.]
• corrected major bleeding risk of ASA+clopidogrel to be the same as warfarin based on ACTIVE-W.
• added tabular view of the risks
• added graphical representation of the risks (requires Adobe Flash to view)

SPARCtool Updated to version 6.1

Release Notes

version 6.1 release notes

• edited mobile/standard links to map to new site www.sparctool.com
• edited sparcnotes links to map to new site and completely rewrote and reorganized SPARCtool Notes
• fixed date field width on regular version
• updated CHADS2 and CHA2DS2-VASc risk estimates to use BMJ 2011;342:d124, 10 year followup estimates.
• upated all the CHADS2 risk descriptors to match the CHADS-VASc one based on BMJ 2011;342:d124, which is paraphrased as "ischemic stroke+thromboembolism"
• updated warfarin population average major bleeding risk from 2.6 to 3.8%/year based on CMAJ November 26, 2012 cmaj.121218
• add a reference for bleeding risk CPR vs. clinician judgement
• added a warning for dabigatran, rivaroxaban, apixaban if "abnormal renal function" is checked in HAS-BLED
• added a disclaimer to top of both tools

The Star Wars That I Used to Know

SPARC Atrial Fibrillation Stroke & Bleeding Risk calculator updated and mobile-friendly

I've updated my SPARC tool to version 6.0.

What's New?

1. A mobile-friendly version that I've tested on the iPhone and which should work on most Android phones. Suggest saving the link to your home screen and it will behave like an app.

2. Some minor updates to both versions such as:

• Changed the efficacy interpretation of the ROCKET-AF (rivaroxaban) trial to "similar to warfarin". It used to report a HR of 0.79 vs. warfarin (based on the primary non-inferiority anaylsis). However, since the superiority analysis was non-significant in the ITT population, the more appopriate interpretation is that rivaroxaban in similar to warfarin.
• clarified wording for aspirin+clopidogrel that the major bleeding risk is based on ACTIVE W showing similar bleeding risk to warfarin, hence the HAS-BLED risk can be used, even though HAS-BLED isn't intended for use in a non-anticoagulated patient.
• minor textual updates

 What's next?

Graphical representations of the stroke and bleeding risk data on the web version. Several users have requested this, which could make it easier to discuss with patients.

Browser-detection so mobile users go direct to the mobile version.