The SAMe-TT2R2 score has been assessed in 15 exclusively AF cohorts,174-185 reporting its predictive ability to forecast good or poor anticoagulation control, with c-statistics ranging from However, these cohorts were predominantly elderly, Western (white) populations, and its predictive ability in non-Western populations has relatively limited data as only 3 studies have assessed with only 1 reporting c-statistics (c-statistic, 0.54; In the multi-ethnic non-white Singaporean population by Bernaitis et al,174 the SAMe- TT2R2 score was able to dichotomize the patients likely to do well on VKA, compared with those (score > 2) more likely to achieve poor TTR. In the Loire Valley AF project, the SAMe-TT2R2 score was predictive of labile INR in AF patients who were VKA users, and was signi cantly associated with the adverse consequences of labile INR, including stroke, serious bleeding, and death; the score was nonpredictive in non-VKA users.179 The score has also been tested in some VTE populations, where it similarly identi es patients likely to achieve a good TTR.187,188 Patients with AF who require OAC should not have to fail with a VKA before they are offered an NOAC; the most appropriate OAC based on the patient s individual risk pro le and patient preference should be offered from the beginning of OAC therapy. However, in some health-care systems where the patient has to have a period on VKA and their TTR determined, before a decision to use an NOAC is approved, the SAMe-TT2R2 score could be used to aid decision-making.173 Recommendation 11. For patients with AF, we suggest the SAMe-TT2R2 score to aid decision-making to help identify patients likely to do well on VKA (Ungraded consensus-based statement). Remark: Those with score 0-2 are likely to achieve a good TTR. 