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Figure 1. The structure of discrete event simulation (DES) model. DES model structure was built based on a priori knowledge about disease progression and possible outcomes of AF patients. The model was designed to predict treatment outcomes conditional on patients’ baseline characteristics. Patients at different stroke and major bleeding risk would trace different probabilistic pathways in the model based on their treatment assignment (rivaroxaban or warfarin). DES could keep track of patient-level covariates and account for the changes in patients’ stroke and bleeding risk factors over time. Therefore, the stroke and major bleeding risk could be modified as the patient got older age or greater comorbidity burden.