PhD defence Minsi Cai

Keywords: Atrial fibrillation, Computational modeling, Screening, Anticoagulation

"From screen to screening: Lifetime simulations of individuals with atrial fibrillation"

This thesis developed a computer model that follows virtual people throughout their lives to study atrial fibrillation, a common irregular heart rhythm that increases the risk of stroke. The model reproduced how the condition could appear, progress, and lead to outcomes such as stroke, bleeding, and death. It was then used to run virtual clinical trials of screening and blood-thinning treatment. The results showed that more intensive screening found more people with atrial fibrillation, but screening everyone produced only a modest long-term reduction in stroke and also caused extra bleeding when logn-term treatment was initiated. The risk-benefit balance was more favorable in people with a higher risk of stroke and in patients with well-treated high blood pressure. The thesis therefore supports a more targeted approach: use patient clinical characteristics and quality of care to decide who is most likely to benefit from screening and treatment, while avoiding unnecessary harm.

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