Frailty and Atrial Fibrillation: A Closer Look at the FRAIL-AF Trial

Introduction

Although evidence-based medicine (EBM) has contributed to establishing the foundations of patient care for over 40 years, scientific principles are still often disregarded in clinical decision-making. As a result, EBM may be mistakenly characterized as a barrier that limits the applicability of poorly recognized concepts, otherwise perceived as thoroughly supported by medical literature. The critical analysis of medical publications should not rely on methods estranged from the scientific realm, and EBM provides the means to limit such hazardous misconceptions.

Despite the continuous progress in medical knowledge, numerous areas of uncertainty persist in clinical practice. In such cases, decision-making typically depends on information originating from dissimilar scenarios, unsuitably designed research or personal experience, and alternatives that are inherently fragile as supporting evidence. Indeed, frailty is a problem that most physicians ultimately have to manage, whether referring to scientific evidence or patient profiles. Greater difficulties arise when both are a source of fragility since misjudged decisions tend to have even poorer outcomes. Atrial fibrillation (AF) is a topic where this association potentially occurs.

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