What this study adds
• A DES model was proposed to predict the counterfactual outcomes of ROCKET AF that would have it been conducted in broader observational study populations.
• Both predicted stroke/SE rate and major bleeding rate were lower in the three observational studies than those in simulated ROCKET AF, which might reflect the real-world event rate in AF patients.
• The results confirmed similar effectiveness and safety to ROCKET AF comparing rivaroxaban and warfarin in the anticoagulation of AF patients.