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Research Article | DOI: https://doi.org/10.31579/2692-9759/186
1Department of Medicine, Addis Ababa University, College of Medicine and Health Science, Addis Ababa, Ethiopia.
2The George Washington University, USA.
3Department of Medicine, Mekelle University, College of Health and Medical Science, Mekelle, Ethiopia.
4Department of Medicine, Santé Medical College, Addis Ababa, Ethiopia.
5Department of Medicine, Hayat Medical College, Addis Ababa, Ethiopia.
6University of California, Berkeley, USA.
7Department of Medicine, Jimma University, Oromia Region, Ethiopia.
8Department of Medicine, University of Bahirdar, College of Medicine and Health Science.
9Department of Medicine, University of Gondar, College of Medicine and Health Science.
*Corresponding Author: Loza Getachew Chane [LozaGC@gmail.com] or Aryamawit Neway Habteyesus [aryamneway89@gmail.com], and Blen Gebremeskel [ blen_gebremeskel@berkeley.edu].
Citation: Melak Mekonnen Ashenafi, Dagmawi Workalemahu Tesfaye, Loza Getachew Chane, Aryamawit Neway Habteyesus, Blen Gebremeskel. et al. (2025), Treatment Outcome Among Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis 2025, Cardiology Research and Reports, 8(1); DOI:10.31579/2692-9759/186
Copyright: © 2026, Melak Mekonnen Ashenafi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 31 December 2025 | Accepted: 07 January 2026 | Published: 13 January 2026
Keywords: atrial fibrillation; global; meta-analysis; outcome; mortality
Introduction: Due to the aging of the global population, atrial fibrillation has become the most prevalent cause of persistent cardiac arrhythmia, and is associated with significant morbidity, including stroke, heart failure, and increased mortality. Despite advances in diagnostic strategies and therapeutic options, there is variation in treatment outcomes. So this study is aimed evaluating treatment outcomes among patients with atrial fibrillation.
Method and Materials: Both manual and electronic searches were used to extract studies for this meta-analysis from PubMed, Google Scholar, Scopus Web of Science, and Cochrane Library was utilized to identify the eligible articles. The identified articles were exported into EndNote software used to export, organize, and review, the eligible articles. The quality of studies was assessed by using the Joanna Briggs Institute (JBI) quality appraisal tool for prevalence study. A meta-analysis was conducted using a random-effects model in STATA Version 14 software.
Result: Eleven included studies with good methodological quality and with 29, 2691participants enrolled in this study. According to this study the pooled proportion of complication was found to be 11.45% (95% CI: 7.48-15.4) and mortality 16.7% (95% CI: 10.9-22.6). The highest prevalence of complication 17.8 % (95% CI: 9.1- 26.5, I2 = 96.1%) was seen in African region, and the lowest 5.75 % (95% CI: -2.9.-14.4, I2 = 99.9%) was seen in North America region and the highest prevalence of mortality 18.6 % (95% CI: 4.1- 33.2,) was seen in African region, and the lowest 17.4 % (95% CI: 9.7. 25.1) was seen in North America region.
Conclusion: This systematic review and meta-analysis found that there is a substantial burden of adverse outcomes among the studied population. So, strengthening health systems, improving early detection, and enhancing management strategies is essential to reduce complications and mortality associated with the atrial fibrillation.
Due to aging of global population, atrial fibrillation (AF) has become the most prevalent and common cause of persistent cardiac arrhythmia, and is associated with significant morbidity, including stroke, heart failure, and increased mortality [1, 2]. It is characterized by high-frequency excitation of the atrium that results in both dyssynchronous atrial contraction and irregularity of ventricular excitation; whereas AF may occur in the absence of known structural or electrophysiological abnormalities [3].
It can affect cardiac function, functional status, and quality of life, significant increase in thromboembolism and confers a stroke risk [4, 5]. It also worsens heart failure and increases mortality in patients with myocardial infarction, and is an independent risk factor for death [6]. Furthermore, atrial fibrillation increases morbidity and mortality for patients and the lifetime risk for atrial fibrillation developing is 1 in 4 [7].
Once diagnosed, there are four cornerstones to management of AF; these are use of anticoagulants, rate control, rhythm control, and risk factor modifications. Despite advances in therapy the long-term clinical outcomes for many patients with AF remain suboptimal [8-10]. Additional challenges include variability in patient preferences, risk stratification, and comorbidities: many patients decline anticoagulation even when guidelines recommend and existing bleeding risk scores do not fully capture individual risk, potentially leading to under/ over treatment [11-13]. .
Atrial fibrillation imposes a substantial and growing burden on patients, healthcare systems, and public health [14]. Despite advances in diagnostic strategies and therapeutic options, considerable variability remains in how patients respond to treatment, influenced by factors such as comorbidities, risk profiles, and adherence to therapy [15]. These challenges emphasizes the need for comprehensive evaluation of treatment outcomes among individuals with AF and also evaluating treatment outcomes provides valuable insight into the effectiveness and safety of current therapeutic approaches. So this study was conducted to estimate treatment outcome of patients with AF.
Objective of the review
The systematic review and meta-analysis was conducted based on the Preferred Reporting Items for Systematic and Meta-analysis (PRISMA) [16].
Inclusion and Exclusion criteria
The inclusion criteria were: (1) participants who are adult, (2) studies which clearly reporting outcome of atrial fibrillation, (3) studies that were conducted in globally, (4) cross-sectional observational studies, and (5) both published and unpublished studies at any time. Articles were excluded if they were: those studies with no clear report of the outcome, and case reports. An attempt was made to contact the corresponding authors using the email address as provided in the published articles.
Searching Strategy
The search strategy was used to explore all relevant published and unpublished studies on the outcomes of atrial fibrillation in the following databases; Pub Med, Scopus, Google Scholar, web of science and Cochrane Library were searched. We reviewed Grey literature using Google. The following core search terms or phrases were used; atrial fibrillation, Atrial flutter OR AF OR Afib OR arrhythmia OR Irregular heart rhythm AND outcome OR prognosis OR mortality OR complication AND global. Search terms were predefined to allow a complete search strategy that included all-important studies. All fields within records and MeSH (Medical Subject Headings) and Boolean operators were used to search in the advanced Pub Med search engine. The gray literature was also searched from institutional repositories.
Study Selection Criteria
The retrieved articles were exported to the reference manager software, EndNote x8, and removed duplicate studies. All reviewers independently screened the title and abstract based on established article selection criteria. The full text of potentially eligible studies was retrieved and assessed in detail against the inclusion criteria. All reviewers independently appraised the quality of the studies by using the Joanna Briggs Institute (JBI) quality appraisal tool for prevalence study [17]. If the quality assessment indicator score was 50% or higher, then the study was considered low risk. Any disagreements that arose between the reviewers were resolved through discussion.
Data Extraction
Data were independently extracted by all authors using a standardized data extraction format. The tool used to extract includes first authors’ name, publication year, study setting, study design, sample size, and the proportion of AF outcome. Articles that fulfilled the predefined criteria were used as a source of data for the final analysis. The reviewers were cross-checked it to ensure consistency. Any discrepancy was solved through discussion with other authors and the procedure was repeated to overcome the difference which resulted during extracting every single study.
The data were extracted using Microsoft Excel and STATA V. 14 statistical software was used for all statistical analysis. The pooled prevalence of the outcome was determined with a random effect model. The Heterogeneity among the included studies was checked with forest plot, I2 test, and the p-values. Heterogeneity among the included studies was investigated with subgroup analysis. Publication bias was checked with a funnel plot. Subgroup analysis was done by region of the study conducted. The results were presented in the form of text, tables, and figures. Additionally, a univariate meta-regression model was applied by taking sample size and publication year investigate the sources of heterogeneity. Finally, a forest plot figure was used to present the point proportions with their 95% CI of the primary studies.
Study selection
Initially, 13485 articles were retrieved: 11830 from PubMed, 987 from Scopus, 123 Google Scholar, 421 web of science and 124 Cochrane Library databases. Eight thousand and five hundred eighty-nine remained after removing duplicates and using automation tools. 5798 articles were screened based on their title and abstracts and removed. Then 1512 articles were screened by using the eligibility criteria. Finally, 11 articles met the eligibility criteria and were included in the analysis (Figure 1).
Figure 1: PRISMA flowchart diagram of the study selection.
Characteristics of study
The 11 studies [18-28] included 29, 2691 participants. Majority of studies were cross-sectional. The sample size ranged from 133 [18] to 260492 [28]. Most studies were conducted in Africa regions. From the included studies, the prevalence of mortality and complication ranged from 0.8[18] to 26.5 [28] and 1.3[26] to 48.9 [18] respectively (Table 1 & 2).
| Author Name | Publication Year | Study area | Study design | sample size | Prevalence of complication with 95% CI |
| Desalegn S, | 2025 | Addis Ababa | cross-sectional | 133 | 48.9(40.4-57.3) |
| Mwita JC, | 2019 | Botswana | cross-sectional | 138 | 11.4(6.09-16.7) |
| Ahmed I, | 2022 | Pakistan | cross-sectional | 636 | 8.6(6.42-10.7) |
| Oyediran IO, | 2021 | Tanzania | cross-sectional | 681 | 7.1(5.17-9.02) |
| D’Anna L | 2024 | Uk | cross-sectional | 959 | 2.8(1.75-3.84) |
| Greffie ES, | 2016 | Gonder | cross-sectional | 240 | 9(5.37-12.6) |
| Addisu ZD, | 2023 | Amhara | cohort | 378 | 17.2(13.3-21.0) |
| Golwala H, | 2016 | Usa | cross-sectional | 9542 | 10.2(9.59-10.8) |
| Piccini JP, | 2016 | USA | cross-sectional | 9743 | 1.3(1.07-1.52) |
Table 1: Characteristics of the included studies in the systematic review and meta-analysis who developed complication
| Author Name | Publication Year | Study area | Study design | sample size | Prevalence of death with 95% CI |
| Desalegn S, | 2025 | Addis Ababa | cross-sectional | 133 | 0.8(-0.7-2.31) |
| Mwita JC, | 2019 | Botswana | cross-sectional | 138 | 14.5(8.62-20.3) |
| Ahmed I, | 2022 | Pakistan | cross-sectional | 636 | 6.7(4.75-8.64) |
| Oyediran IO, | 2021 | Tanzania | cross-sectional | 681 | 34(30.4-37.5) |
| D’Anna L | 2024 | UK | cross-sectional | 959 | 6.4(4.8-7.9) |
| Greffie ES, | 2016 | Gonder | cross-sectional | 240 | 31.2(25.3-37.0) |
| Addisu ZD, | 2023 | Amhara | cohort | 378 | 13.22(9.8-16.6) |
| Golwala H, | 2016 | USA | cross-sectional | 9542 | 15.91(15.1-16.6) |
| Piccini JP, | 2016 | USA | cross-sectional | 9743 | 11.2(10.5-11.8) |
| Inohara T, | 2018 | USA | cohort | 9749 | 25.2(24.3-26.0) |
| Ngo LT, | 2024 | Australia & New Zealand | cross-sectional | 260492 | 26.5(26.3-26.6) |
Table 2: Characteristics of the included studies in the systematic review and meta-analysis who were died.
Treatment outcome of atrial fibrillation
In this study two outcomes were extracted namely mortality and development of complication. Eleven studies reported death as the treatment outcome with a total participant of 26, 0492 and nine studies reported development of complication with a total participant of 22450. The pooled proportion of complication was found to be 11.45% (95% CI: 7.48-15.4) with a heterogeneity index of 99.2%, with a P-value of less than 0.001(Figure 2). The pooled proportion of mortality was found to be 16.7% (95% CI: 10.9-22.6) with a heterogeneity index of 99.8%, with a P-value of less than 0.001(Figure 3).
Figure2: Forest plot showing pooled global prevalence of complication as treatment outcome of patients with atrial fibrillation.
Figure 3: Forest plot showing pooled global prevalence of mortality as treatment outcome of patients with atrial fibrillation.
Sub-group analysis
The subgroup analysis was conducted based on region of the studies conducted. The highest prevalence of complication 17.8 %( 95% CI: 9.1- 26.5, I2 = 96.1%) was seen in African region, and the lowest 5.75 %( 95% CI: -2.9.-14.4, I2 = 99.9%) was seen in North America region (Fig. 4). Also, prevalence of mortality 18.6 %( 95% CI: 4.1- 33.2, I2 = 98.9%) was seen in African region, and the lowest 17.4 %( 95% CI: 9.7. 25.1, I2 = 99.7%) was seen in North America region (Fig.5).
Fig 4: Subgroup analysis of global prevalence of complication patients with atrial fibrillation by region.
Fig 5: Subgroup analysis of global prevalence of mortality patients with atrial fibrillation by region.
Meta-regression and publication bias
The heterogeneity index values (99.2 %and 99.8%) indicated that the studies were heterogeneous. Therefore, meta-regression was conducted using year of publication and sample size as a covariates. The analysis showed that publication year and sample size didn’t have a significant effect on heterogeneity between studies for mortality, with a P- value of 0.417 and 0.053 respectively and for complication a P- value of 0.212 and 0.372 respectively. Publication bias was assessed using a funnel plot and the Egger regression test with a significance threshold of <0.05. Statistical evidence of publication bias was not observed for both mortality and complication. The funnel plot displayed some asymmetry in the distribution (Fig. 6 & 7) and the Egger test yielded a statistically non-significant result with a P-value of 0.057 and 0.080 for complication and mortality respectively.
Fig 6. Funnel plot to test the publication bias in 9 studies with 95% Confidence limits.
Fig 7. Funnel plot to test the publication bias in 11 studies with 95% Confidence limits.
Sensitivity analysis
Sensitivity analysis was performed to determine how various sources of uncertainty contribute to the overall uncertainty among the studies, but the results indicated that uncertainty has an insignificant influence on pooled prevalence (Fig 8 &9).
Figure 8: Sensitivity analysis of pooled global prevalence complication among patients with atrial fibrillation for each study being removed one at a time.
Figure 9: Sensitivity analysis of pooled global prevalence of mortality among patients with atrial fibrillation for each study being removed one at a time.
Evidence shows that early rhythm controlling in patients with atrial fibrillation significantly improves clinical outcomes. This will reduces the composite of cardiovascular death, stroke, hospitalization for heart failure, or acute coronary syndrome. Furthermore, in patients with recent ischemic stroke and AF early initiation of DOAC anticoagulation did not significantly increase bleeding risk and was associated with a trend toward reduced recurrent ischemic events at 90 days [29-32].
The pooled proportion of complication was found to be 11.45% (95% CI: 7.48-15.4). The pooled proportion of mortality was found to be 16.7% (95% CI: 10.9-22.6). A study indicated that on newly diagnosed AF patients, the annual death rate was reported around ~5% and among most patients early after diagnosis, mortality and complications are higher [33, 34]. Different studies shows the outcomes in AF vary strongly depending on age, comorbidities (frailty, heart failure, and renal disease), use of anticoagulation, and whether patients undergo procedures [35, 36].
According to sub-group analysis the highest prevalence of complication 17.8 % (95% CI: 9.1- 26.5,) was seen in African region, and the lowest 5.75 % (95% CI: -2.9.-14.4) was seen in North America region. The discrepancy might be due to disparities in healthcare infrastructure, access to anticoagulation and advanced AF treatment, comorbidity burden and late presentation, and differences in study populations.
Additionally, the prevalence of mortality 18.6 % (95% CI: 4.1- 33.2) was seen in African region, and the lowest 17.4 % (95% CI: 9.7. 25.1) was seen in North America region. This variation explained as limited access to advanced cardiovascular Care, underuse and Limited availability of anticoagulation, variation in burden of comorbidities, delayed diagnosis, differences in study populations and clinical settings.
This systematic review and meta-analysis found that the overall pooled proportion of complications among the included studies was 11.45%, while the pooled proportion of mortality reached 16.7%, indicating a substantial burden of adverse outcomes among the studied population. So, strengthening health systems, improving early detection, and enhancing management strategies is essential to reduce complications and mortality associated with the atrial fibrillation.
Strength and limitation of the study
There are certain limitations to be considered. First the lack of limited studies from most regions may impact the generalizability of the findings, secondly we are unable to compare with other findings due to there is no systematic review and meta-analysis conducted globally and regionally.
Ethics approval and consent to participant
Not applicable
Consent for publication
Not applicable
Availability of data and materials
All the data analyzed during the current systematic review and meta-analysis is fully available with request from corresponding author.
Competing interests
all the authors declare that they have no competing interests
Funding
Not applicable.
Acknowledgment
We would like to thank all authors of studies included in this systematic review and meta-analysis.
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My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
