Utilization Management System Research Articles

Geospatial aspects of building information modelling (BIM) based utilities management

The concept of Building Information Modelling (BIM) which was originally used for construction design has developed with increasing BIM dimensions from 3D, 4D, 5D, 6D, 7D to 10D and with the addition of semantics to 3D objects so that BIM allows it to be developed in broader management such as utility and assets management. In a utility management system, object data acquisition process will face some problem in varying object’s dimensions and location require the merging of several 3D data which is collected from different equipment with different accuracy and precision which for this research using the High Definition Surveying (HDS) method from Terrestrial Laser Scanning (TLS) and Handheld Laser Scanning (HLS) instruments. The problem that arises is in point cloud data merging process with different point densities, in this paper merging data will use Helmert 3D transformation method. Another problem is in the objects georeferencing into the Earth coordinate system. A georeferenced system is needed to integrate all of utility object into a utility management system in a building. This process is necessary if the development of utility database management will be linked with the creation of 3D models in the bigger scopes such as smart cities or narrower scopes such as smart buildings. The end result is a georeferenced BIM-based utility database management system, which allows for spatial analysis or automation using coordinate systems embedded in 3D objects.

Strategies for Increasing the Productivity of Goat Farming Business in the Era of Industry 4.0 in Banyumas District

The development of goat breeding business needs to be done so that the business can compete in the era of industrial 4.0. The study aims to formulate the strategy to increase productivity in goat breeding business on the 4.0 industry era. The study used survey methods. Determination of the sample was done using stratified random sampling that took the region based on high land, moderate and low land. Then, on each level was taken by criteria of number of goats and the dominant species. Number of sample was determined using Nomogram Harry King and the total respondents was 322 farmers. The analysis used was Causal Loop Diagram modeling and Qualitative Descriptive. The results show that to increase the productivity of goat breeders can be done with optimize Information and Communication Technology (ITC) in production factors, utilization management system application and the inovation of feed technology, optimize smartphone as promotion and trading tools, share the information via social media, supply of information service based on website or application and transformation of extension to virtual extension.

P525: Laboratory utilization management system assists with familial cytogenetic testing: 3 case examples

P525: Laboratory utilization management system assists with familial cytogenetic testing: 3 case examples

Clinical Lab Decision Support System for Quality Test Ordering and Utilization with Increase Reimbursement

Abstract Introduction/Objective It is estimated that at least 20% of the 5 billion lab orders submitted annually are inappropriate. Use of an appropriate laboratory test utilization management system (TUMS) can significantly overcome this. Laboratory Decision System (LDS) is the only automated TUMS to assist providers understand, select, order, and optimally utilize tests for disease diagnosis and management. This algorithm-based LDS rates and scores potential tests for any given disease and assigns an interpretable numeric score based on clinical relevance, medical necessity, and indication. Importantly, every orders using LDS will also have right CPT and ICD-10 codes assigned to meet the medical necessity and improve reimbursement. Therefore, in this study, we evaluated the performance of LDS as a testing utilization management system and its ability to improve the reimbursement. Methods/Case Report A total of 96,170 lab orders were analyzed from a reference laboratory. Of these, 814 tests were accompanied by an invalid ICD10 code and 44,671 tests or were accompanied by ICD10 that are described by Medicare as “never covered” because of inability to meet medical necessity. A total of 160,449 tests were subject to an Medicare policy review from which 112,400 tests met coverage criteria and 48,049 tests did not. These orders were then reevaluated using LDS, which can be accessed from app.medicaldatabase.com/site/api/cpoe or interfaced with EMR to determine if the system would have improved test selection and reimbursement. Results (if a Case Study enter NA) Of the original test order sample, 91.5% had an associated LDS score. Of these scored tests, 47.80% met coverage and 43.73% failed to meet coverage, according to the LDS Ranking System. Importantly, LDS provided recommendations for alternative diagnostic ICD10 codes or tests which could have aided physicians in choosing a more appropriate test or submitting a different ICD10 diagnostic code to meet medical necessity. 96.4% with an alternative ICD10 code or test with a score above 5, meeting medical necessity. 80.5% were recommended by the LDS system which would meet Medicare policies. Conclusion Use of such algorithm-based testing selection and ordering database that rates and scores potential tests for any given disease based on clinical relevance, medical necessity, and testing indication, would eventually help providers to select and order right test and reduce miss-utilization of tests.

The Design of University Coordination Utility Management and Online Repair Platform Based on Multivariate Statistical Analysis with Random Matrix

In this paper, the random matrix of multivariate statistical analysis is used to conduct in-depth research and analysis of the university coordination utility management and online repair platform. Considering that the chunking of variables based on mechanistic knowledge is not easy to achieve, firstly, the maximum correlation and minimum redundancy algorithm is used to portray the correlation more accurately between process variables and remove the redundancy between variables to provide the optimal variable input for the base model. The multivariate mean control chart was used to calculate the offset between the data of each test group of the contact network and the overall mean and standard values of the contact network parameters under different correlations among the contact network parameters. Based on the daily work research and process document sampling of the university coordination utilities management department, the requirement analysis and design of the target system were completed, and a university coordination utility management system based on BS architecture was developed. Student information is lost, data statistics are wrong, etc., so that the business work of other departments of the school cannot be carried out smoothly. The whole platform can be divided into several submodules according to the functions: super administrator module, administrator module, staff module, and user module, and the detailed design scheme of each module is described in detail. At the same time, the logistic regression model is trained using the collected data sets, and the training scheme of the model is designed. The mathematical model of logistic regression and the related algorithm are used to decide whether to purchase maintenance equipment at this stage and the quantity of purchase. Finally, a new monitoring index is proposed to monitor the process status. MNPE-GMM not only maintains most of the local structural information of the window dataset in the feature subspace but also reduces the computational complexity of GMM in the fault detection process. The MNPE-GMM method can effectively improve the fault detection rate of multimodal intermittent processes by introducing new statistics.

Performance Evaluation of Public Management in View of Fuzzy DEA Model

The research on management performance evaluation and governance countermeasures of public utilities, as an important entry point, focus, and flash point of the combination of management science, engineering research, and public management research, not only highlights the implementation and implementation of the scientific outlook on development and correct outlook on political performance, so that the topic has distinct theoretical frontier, practical pertinence, and practical guidance. It also highlights the intersection and integration of multiple disciplines, combines normative research with empirical research, qualitative research with quantitative research, macro research with micro research, and method and technology research with concept innovation and institutional arrangement research, and strives to realize the integration and complementarity of research methods of management science and engineering and public management. The research of public management broadens new horizons, expands new fields, and provides new paradigms, methods, and means. Based on the weight of public utilities management performance evaluation indicators and the selection of empirical samples, this paper studies the basic principles and comparative advantages of fuzzy comprehensive evaluation model and DEA model, makes an empirical evaluation of public utilities management performance, draws evaluation conclusions, and analyzes the key factors affecting and restricting the level of public utilities management performance. From the research level of evaluation technology and methods to the level of institutional arrangement, it is the only way to realize the scientific, standardized, and institutionalized performance evaluation of local government public utilities management. The basic procedures of performance evaluation and the performance evaluation mechanism are introduced, and the establishment and improvement of the information fidelity system and result application system of public utilities performance evaluation are studied. Based on the evaluation conclusion and empirical analysis of public utilities management performance, aiming at the key factors affecting the level of public utilities management performance, this paper puts forward the governance countermeasures of public utilities from the aspects of establishing scientific public utilities management performance concept, innovating public utilities management system, establishing and perfecting public utilities investment management mechanism, and so on.

BIM-GIS-Based Integrated Framework for Underground Utility Management System for Earthwork Operations

Underground utilities are important assets that provide basic services for society’s daily life. They are generally very complex and remain unnoticed until they fail due to any particular reason. The stakeholders involved in the design, construction, and maintenance of utility infrastructure face many problems due to the traditional underground utility management system, resulting in injuries, loss of life, disruptions, project delays, and financial loss. The problem with the traditional system is that it uses 2D drawings and keeps unreliable information or a lack of updated information, which makes it an inefficient utility management system. With the advancement in construction information technology, we can address this effectively by integrating BIM and GIS. In this paper, a novel integrated BIM-GIS framework for underground utility management systems was developed on the basis of IFC to CityGML mapping. It provides an effective underground utility management system that facilitates designers in optimization of the design, assists in the excavator’s operator by providing real-time three-dimensional spatial information during the construction process, and acts as an as-built information database for utility facility management. For validation, a real-time project case study indicated that the proposed system can effectively provide comprehensive underground utility information at different project stages.

The harm of anticoagulation in patients with low-risk by CHADS2 and reclassified as high-risk by CHA2DS2VASc: inferences from TRAF cohort.

There is a gap in the knowledge concerning oral anticoagulation (OAC) in atrial fibrillation (AF) patients with a non-high risk of stroke. CHA2DS2VASc and CHADS2 scores generated imprecise risk estimates for low risk patients. We aimed to assess OAC in patients with low risk by CHADS2 and reclassified as high-risk by CHA2DS2VASc. In this study, retrospective nationwide population-based study, data were obtained from the Turkish claims and utilization management system. Patients with non-valvular AF (n=451,113) between 2007 and 2012 sub-divided into those with a CHA2DS2VASc≥1 and CHADS2=0 (n=41,273) who were off-warfarin (n=29,448) and on-warfarin (n=11,825). Stroke and systemic embolism, major bleeding, all-cause mortality, net clinical benefit (NCB) and ultimate NCB (UNCB) were assessed. Of the total cohort (mean age 66.1 ± 14.1 years, 56.1% female), CHA2DS2VASc improved the net reclassification index of observed 5-year composite thromboembolic endpoint by 6.9% (p<0.05). CHA2DS2VASc reclassified 9.7% low risk patients as high risk. Among reclassified-high-risk category (patients with a CHA2DS2VASc score of ≥1 and CHADS2 score of 0), major bleeding for that prescribed warfarin was 3% and higher than the rate of thromboembolism among those off-warfarin. NCB (-0.035) and UNCB (-0.021) were negative. Death and hospitalization at 1 year were significantly higher for on-warfarin group. Clinical outcomes, net clinical benefit indices are negative; rates of death and hospitalization were significantly higher for OAC in reclassified category. This emphasizes the importance of greater attention to balancing the risks and benefits of OAC in patients with low risk by CHADS2 and reclassified as high-risk by CHA2DS2VASc.

Integration of Digital Technologies into Underground Utility Asset Management

Installation, detection, maintenance, mapping, and management of underground utility assets present challenges to owners, engineers and contractors. Industry-wide practices include the use of geophysical and similar technologies to determine depth and location, and 2D as-built plans integrated with GIS databases for information management. The feasibility of incorporating 3D BIM models of the subsurface to replace the 2D plans to improve visualization and data management is examined in this paper. Obtaining an accurate image of the underground infrastructure would help minimize excavation accidents due to equipment-utility collisions and prevent property damage. Further, the inclusion of automated data collection and sharing features realized through BIM technology can enhance operations of smart cities. The research methodology consists of a state-of-the-art review of the current underground utility management systems, combined with statistical analysis of survey responses received from utility providers and one-call centers in the U.S. Three categories of utility practices are identified based on the level of digital technology integration. It is found that a vast majority of utility firms have adopted GIS databases with 2D plans, depth and other asset information, while a smaller percentage of providers have achieved full GIS-BIM integration, incorporating a wide range of asset data. Future progress on broader implementation appears to be constrained by the digital literacy of personnel and high costs of technology acquisition and application. A three-step framework for converting 2D plans to 3D BIM models is also presented and discussed. The process model proposed for this purpose allows the utilization of commercially available software with minimal need for additional coding.

Artificially Intelligent Response Based Utility Management System

Every organization should have its very own Personal AI Assistant at its disposal. The aim of the assistant is to find a knowledge gap to fill by its well-structured speech synthesis and generation mechanisms. The inquiry or interrogation can be predominantly generic to the requirements of the institution. The assistant will understand based on the clarity of purpose. Responses are original, innovative, clear and concise as its vital to provide correct up to date information. They can also be visual and graphical based on the question. Extracted data from private data sets of the organization are analyzed and organized using Pandas. Speech Recognition, Understanding, and Synthesis are done using Speech Recognition Packages and Natural Language Processing Techniques.

PMS68 - HOSPITAL PHARMACY CENTRALIZED PROCESS FOR HOSPITAL-WIDE MANAGEMENT OF BIOSSIMILARS USE AND ITS EFFICIENCY

Efficient implementation of biosimilars policy at hospital level involves different internal and external stakeholders. This research aims to provide a detailed description and an efficiency assessment of the policy implemented by Centro Hospitalar e Universitário de Coimbra (CHUC) as a hospital pharmacy centralized, Fully Integrated Biosimilars utilization management System (FIBS). A mapping of the entire FIBS process was performed, from initial prescription to until dispensing and monitoring of biologics therapy. The step by step process and interdependencies between different stakeholders were implemented in Anylogic, a multi-paradigm simulation software. Efficiency assessment was performed by the extend of switching to or initiation of biosimilars by month, after policy implementation in October 2017 for etanercept, infliximab and rituximab. FIBS relies on prescription and dispensing by international non-proprietary name. Hospital Medicines and Therapeutic Committee (HMTC) recommends the initiation of or switching to (for patients with at least 12 months on same biologic brand) the option with the best economic value. Non-biosimilar utilization has to be clinically justified on a patient by patient basis by prescribing physicians. The latter decision needs to be validated by the Hospital board, HMTC and Hospital Pharmacy which acts as system gate keeper. Total traceability including biologic identification by tradename and batch number was fully demonstrated (100% of dispensed biologics) for the 602 patients analysed: rheumatic (36.2%), gastrointestinal (28.6%) and hematologic (20.4%) diseases. Utilization of biosimilars (54.6%) surpassed branded drugs (45.4%) after just 3 months of FIBS implementation. In May 2018 biosimilars quota were: etanercept (87.7%); infliximab (88.4%); rituximab (61.9%). Overall rapid biosimilar utilization was more related to switching to (70%) than initiation of biosimilars (30%) in naïve patients to biologics. The Fully Integrated Biosimilars utilization management System of CHUC demonstrate high levels of efficiency, integration and control over the utilization of biosimilars at hospital level.

Improving electric vehicle utilization in carsharing: A framework and simulation of an e-carsharing vehicle utilization management system

Rapid economic growth and urbanization have motivated economists and researchers to seek innovative solutions for the many challenges that accompany these trends. This can be observed in upcoming research in sustainable transportation services where potential solutions to urban mobility issues are being explored. For example, e-carsharing, which involves the joint ownership or use of battery electric vehicles (BEVs) does not only mitigate the environmental and infrastructural hazards of privately owned internal combustion engine vehicles (ICEVs) through reduction of emissions and urban traffic, but also alleviates many barriers such as high costs, battery life limitations, and suboptimal charging infrastructures that have prevented privately owned BEVs from reaching their full potential.In response, we present a framework for a battery electric vehicle utilization management system (BEVUMS) for automated optimization of operational decisions regarding the usage of electric vehicles in mixed vehicle-type fleets. The framework consists of four modules: energy demand prediction, battery charge scheduling, vehicle selection, and vehicle relocation. We assess the validity and capabilities of the system by simulating an e-carsharing system with data sets of 2,000 and 20,000 vehicle rental data points. Our findings suggest opportunities for prevention of charging related problems, increased BEV rental ratios, and lengthened BEV rental periods. Thus, the proposed system leads to improved BEV utilization and prolonged BEV battery life. In addition to these opportunities for increased potential sustainability provided by our proposed BEVUMS, this study further contributes to current research in the field by providing a framework and a benchmark setting for future research.

О НОРМАТИВНОМ РЕГУЛИРОВАНИИ ВНЕДРЕНИЯ АВТОМАТИЗИРОВАННЫХ СИСТЕМ УПРАВЛЕНИЯ ЗДАНИЕМ «УМНЫЙ ДОМ» В СФЕРЕ ЖКХ

The article presents the results of the study of the conditions for the implementation of the “Smart Home” automated building management systems (APCS) for use in multi–apartment residential buildings. The analysis of the current regulatory framework in the field of housing and communal services, as well as technical regulation of the application of individual elements of the IMS, with the possibility of their integration into the urban housing and utilities management system, was carried out. The proposed directions for improving the regulatory framework and technical regulation of the subsystem for the AESU subsystem will ensure mass introduction and integration of the housing and utilities system into the Smart City system.

Heterogeneous message conversion for remote buried utility management system IoT(Internet of Things) gateway

Heterogeneous message conversion for remote buried utility management system IoT(Internet of Things) gateway

Prognostics and health management of life-supporting medical instruments

In order to deal with the maintenance problems of life-supporting medical instruments, and to improve their utilization, a prognostics and health management (PHM) system is designed. The implementation framework of PHM system is proposed. A experiment platform for critical components of life-supporting medical instruments is built. A fault is injected into the component. The model for critical components of medical instruments is established based on Lagrange method model. Using the reduced particle group to represent the state of the probability density function, the probability of failure in real-time can be calculated by particle filter algorithm. The simulation results match the experimental data. It diagnoses the faults and predicts the remaining useful life. Then appropriate maintenance advice can be given.

Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital.

To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team. Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.

Management of Utilization and Development of the Production Capacity of the Military-Industrial Complex

The article deals with the issue of efficient utilization and development of the production capacity of the military-industrial complex companies comprising integrated structures (mainly, state corporations). This issue is essential for the Russian military-industrial complex which faces the deficit of investment resources and the need for urgent implementation of large-scale production plans. The article suggests the ways to assess the resource management’s efficiency in the integrated structures’ companies, including utilization and development of capacities of specific companies. The production capacity-based integrated indicator of management efficiency (which may be estimated on the basis of directly measurable values) was developed. It shows the potential increase in the integrated structures’ production capacities without additional investments, solely due to resource management’s enhancement in the member companies. Business tools for improvement in the production capacity management efficiency were also explored. Efficiency indicator was suggested for development of production capacity of the integrated structures’ companies, and the optimal principles of selection of investment recipients are explained for 2 scenarios: when complete production cycle is preserved at each company, and when the companies become specialized within integrated structures. Business tools for making optimal investment decisions with regard to information asymmetry and opportunism of companies’ managers are described. The analysis allowed to develop the structure and algorithms of integrated structures of the production capacity utilization and development management system on the tactical level (capacities utilization management), the strategic level (capacities development management) and the superstrategic level (capacity maintenance, particularly using the technologies and production capacities of machine tool builders). DOI: 10.5901/mjss.2015.v6n5s4p327

Utility Management System Cost and Time Benefits and Implications from the Local Agency Perspective

AbstractUtility management systems (UMSs) have become more common for government agencies, and their use has recently been advocated by AASHTO on a statewide basis. By identifying current utility locations and correlating utility-related information between ongoing and upcoming projects, UMSs can reduce the occurrence of unexpected delays and cost overruns resulting from unforeseen utility conflicts found during construction. This paper presents an analysis of a two-part survey of local agency professionals in the transportation industry, regarding perceptions of UMS cost and time benefits and implications associated with implementation. The paper evaluates two hypotheses regarding local agencies’ perception on two key areas: (1) impact of UMS cost and time implementation requirements on implementation decisions; and (2) difference in cost and time benefits and implications for different types of local agencies. The study finds that despite its obvious potential benefits, UMSs are not being widely impleme...

OP-242 Time to Ischemic Stroke/Embolism in Patients with Atrial Fibrillation: Analysis from a A Nationwide Cohort-TRAF (TuRkish Atrial Fibrillation Data Base)

ObjectiveAtrial fibrillation (AF) is the most common arrhythmia and it is associated with a five-fold risk of stroke. Atrial fibrillation associated ischaemic strokes and embolisms are more disabling and fatal. We aimed to investigate the time to ischemic stroke/embolism after the diagnosis of AF in patients who never used warfarin.MethodsWe analyzed the records of 402674 patients over the age 18 who had the diagnosis of non-valvular atrial fibrillation (AF) according to ICD-10 code I48 from a nation-wide claims and utilization management system which processes claims for all health insurance funds in Turkey since 2007. In this study we have used completely anonymized data. Time-to-event analysis were used to measure the time to ischemic stroke/embolism after being diagnosed with AF.ResultsA total of 28187 AF patients (7 %) had ischemic stroke or emboli. Time to ischemic stroke and emboli was 61,25±0,05 months from the first diagnosis of AF. Stroke/emboli was observed earlier in the patients with CHA2DS2-VASc score >= 2; mean 60,72±0,06 months. Stroke/emboli was observed in patients with CHA2DS2-VASc score 0 and 1 in mean 65,39±0,11 months and mean 65,02 ±0,09 months respectively.Conclusions ObjectiveAtrial fibrillation (AF) is the most common arrhythmia and it is associated with a five-fold risk of stroke. Atrial fibrillation associated ischaemic strokes and embolisms are more disabling and fatal. We aimed to investigate the time to ischemic stroke/embolism after the diagnosis of AF in patients who never used warfarin. Atrial fibrillation (AF) is the most common arrhythmia and it is associated with a five-fold risk of stroke. Atrial fibrillation associated ischaemic strokes and embolisms are more disabling and fatal. We aimed to investigate the time to ischemic stroke/embolism after the diagnosis of AF in patients who never used warfarin. MethodsWe analyzed the records of 402674 patients over the age 18 who had the diagnosis of non-valvular atrial fibrillation (AF) according to ICD-10 code I48 from a nation-wide claims and utilization management system which processes claims for all health insurance funds in Turkey since 2007. In this study we have used completely anonymized data. Time-to-event analysis were used to measure the time to ischemic stroke/embolism after being diagnosed with AF. We analyzed the records of 402674 patients over the age 18 who had the diagnosis of non-valvular atrial fibrillation (AF) according to ICD-10 code I48 from a nation-wide claims and utilization management system which processes claims for all health insurance funds in Turkey since 2007. In this study we have used completely anonymized data. Time-to-event analysis were used to measure the time to ischemic stroke/embolism after being diagnosed with AF. ResultsA total of 28187 AF patients (7 %) had ischemic stroke or emboli. Time to ischemic stroke and emboli was 61,25±0,05 months from the first diagnosis of AF. Stroke/emboli was observed earlier in the patients with CHA2DS2-VASc score >= 2; mean 60,72±0,06 months. Stroke/emboli was observed in patients with CHA2DS2-VASc score 0 and 1 in mean 65,39±0,11 months and mean 65,02 ±0,09 months respectively. A total of 28187 AF patients (7 %) had ischemic stroke or emboli. Time to ischemic stroke and emboli was 61,25±0,05 months from the first diagnosis of AF. Stroke/emboli was observed earlier in the patients with CHA2DS2-VASc score >= 2; mean 60,72±0,06 months. Stroke/emboli was observed in patients with CHA2DS2-VASc score 0 and 1 in mean 65,39±0,11 months and mean 65,02 ±0,09 months respectively. Conclusions

OP-244 Warfarin Use in Patients with Nonvalvular Atrial Fibrillation: Analysis From A A Nationwide Cohort-TRAF (Turkish Atrial Fibrillation Data Base)

Objective: Atrial fibrillation (AF) is the most common arrhythmia and it is associated with a five-fold risk of stroke. Atrial fibrillation associated ischaemic strokes and embolisms are more disabling and fatal. We aimed to investigate the time to ischemic stroke/embolism after the diagnosis of AF in patients who never used warfarin. Methods: We analyzed the records of 402674 patients over the age 18 who had the diagnosis of non-valvular atrial fibrillation (AF) according to ICD-10 code I48 from a nation-wide claims and utilization management system which processes claims for all health insurance funds in Turkey since 2007. In this study we have used completely anonymized data. Time-to-event analysis were used to measure the time to ischemic stroke/embolism after being diagnosed with AF. Results: A total of 28187 AF patients (7 %) had ischemic stroke or emboli. Time to ischemic stroke and emboli was 61,25 0,05 months from the first diagnosis of AF. Stroke/emboli was observed earlier in the patients with CHA2DS2-VASc score >1⁄4 2; mean 60,72 0,06 months. Stroke/emboli was observed in patients with CHA2DS2-VASc score 0 and 1 in mean 65,39 0,11 months and mean 65,02 0,09 months respectively. Conclusions: Stroke/emboli was observed in a significant portion of AF patients in 5 years, and increased risk score decreased time to ischemic/embolic event. Stroke/emboli is one of the most important adverse events in AF patients and contributes to mortality and observed earlier in patients with higher risk scores. Therefore anticoagulation and strict control is needed. Figure 1. Warfarin Use according to CHA2DS2-VASc Score -OP-243 Results of Anticoagulation in Patients with CHADS2 Score of 0 and CHA2DS2VASC Score of 1; An Investigation Using the National Turkish Atrial Fibriallation (TRAF) Registry. B. Yavuz, N. Ata, E. Oto, K. Aytemir, S. Okutucu, B. Evranos, D.K. Ozturk, R. Koselerli, E. Ertugay, Y.G. Ilhan, A.J. Camm, A. Oto. Kecioren Teaching and Research Hospital; Social Security Institution; Hacettepe University Faculty of Medicine; MITS; St George’s Medical School, London. The American Journal of Cardiology MARCH 13e16, 2014 10 IN AND C Objective: Atrial fibrillation is associated with ischaemic strokes. Stroke risk is not homogenous and is identified by risk stratification schemes created by adding the risk factors.A new risk score, CHA2DS2VASC risk scheme was developed to decrease the intermediate risk group of CHADS2 risk scheme and to decrease the confusion about anticoagulation. But it has also created a new confusion on anticoagulation of very low risk group of patients. Therefore to detect the effect of anticoagulation in CHADS2 score of 0 and CHA2DS2VASC score of 1 patients we compared offwarfarin and onwarfarin patientswhoseCHADS2 score was 0 and CHA2DS2VASC score was 1. Methods: We analyzed the records of 402674 patients over the age 18 who had the diagnosis of non-valvular atrial fibrillation (AF) according to ICD-10 code I48 from a nation-wide claims and utilization management system which processes claims for all health insurance funds in Turkey since 2007. In this study we have used completely anonymized data. Results: Twenty one percent of on warfarin group and 16% of off warfarin group was hospitalized over 5 years follow up. Major hemorrhage was more frequently encountered in on warfarin group than off warfarin group (2,7% and 1,3 respectively). Stroke/TIA/Systemic Embolism/Death composite endpoint was higher in on warfarin group than off warfarin group, (7,8% and 4,6% respectively). Conclusions: This analysis showed that both hospitalization and major hemorrhages were higher in on warfarin group and warfarin did not decrease the joint endpoint of thromboembolism and death in this low risk group. Therefore this result directs us to question the intermediate risk categorization of CHA2DS2VADSc risk scheme.