This Figure, created for this special publication of The American Journal of Medicine, illustrates in flow-chart form how the scoring system of CHA₂DS_2-VASc might be used:  

•   For a score 2–6 on the simpler CHADS₂ scoring system, the patient should be anticoagulated, without question;  Importantly, this does not mean antiplatelet therapy with aspirin; it means use of an anticoagulant, whether that is warfarin or one of the newer Factor XA or direct thrombin inhibitors.  
• For a CHADS₂ score of 1 or 0, the physician calculate the CHA₂DS₂-VASc score.  For a CHA₂DS₂-VASc score of 2, the patient should be anticoagulated; for a CHA₂DS₂-VASc score of 1, it is up to the physician’s professional discretion. 
• Once the better low-risk calculating CHA₂DS₂-VASc score is 0, it is possible to use aspirin – or nothing.  

This novel flow chart takes into consideration careful review of the data from the prior studies presented in the preceding discussion. 

Reiffel JA. Am J Med 2013; 126: 00-00.