{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:13:03Z","timestamp":1788347583312,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Comparative data between the HAS\u2010BLED, GARFIELD\u2010AF and ORBIT score are limited in anticoagulated Asian patients with atrial fibrillation (AF). We compared the performance of the 3 scores in a nationwide registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>AF patients treated with oral anticoagulants in the COOL\u2010AF registry were studied. We fitted the variables of the HAS\u2010BLED, GARFIELD\u2010AF and ORBIT score to major bleeding in Cox model. We explored a modified HAS\u2010BLED by addition of sex and body weight. Discrimination, calibration, net reclassification index (NRI) and decision curve analysis were used to compare the performance of the 3 models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 3402 patients in the registry, 2568 patients who received oral anticoagulant at baseline were studied. Majority of patients (91.1%) received warfarin. The rate of major bleeding was 2.11 per 100 person\u2010years. The C\u2010statistics of the GARFIELD\u2010AF, HAS\u2010BLED, modified HAS\u2010BLED and ORBIT score were 0.65 (95% confidence interval [CI] 0.63\u20130.67), 0.66 (95%CI 0.64\u20130.68), 0.69 (95%CI 0.67\u20130.71) and 0.64 (95%CI 0.62\u20130.66) respectively. There was good agreement between predicted and observed bleeding in the deciles of HAS\u2010BLED and GARFIELD\u2010AF scores, while the modified HAS\u2010BLED score and ORBIT score overestimated the risk in the last decile. The modified HAS\u2010BLED score had superior NRI than the HAS\u2010BLED score (26.9%, 95%CI 9.7%\u201342.2%) and the ORBIT score (31.9%, 95%CI 9.0\u201353.6%). The NRI between the modified HAS\u2010BLED and GARFIELD\u2010AF score was similar. The net benefit curve of the 4 models were overlapping among different thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The clinical utility for bleeding prediction of GARFIELD\u2010AF, HAS\u2010BLED, modified HAS\u2010BLED and ORBIT scores were similar in anticoagulated Asian patients with AF participating in the COOL\u2010AF registry. We found no advantage of the ORBIT over HAS\u2010BLED score for bleeding risk prediction, even in direct oral anticoagulant users.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15716","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T07:39:41Z","timestamp":1679384381000},"page":"2472-2482","source":"Crossref","is-referenced-by-count":7,"title":["Comparative validation of HAS\u2010BLED, GARFIELD\u2010AF and ORBIT bleeding risk scores in Asian people with atrial fibrillation treated with oral anticoagulant: A report from the COOL\u2010AF registry"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3650-8661","authenticated-orcid":false,"given":"Ply","family":"Chichareon","sequence":"first","affiliation":[{"name":"Cardiology Unit, Division of Internal Medicine, Faculty of Medicine Prince of Songkla University  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjbordin","family":"Winijkul","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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