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Opportunistic detection of atrial fibrillation using blood pressure monitors: a systematic review.

Kane SA, Blake JR, McArdle FJ, Langley P, Sims AJ - Open Heart (2016)

Bottom Line: Values for the sensitivity and specificity of AF detection were extracted from each paper and compared.But the studies used different methodologies and many were subject to potential bias.More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during BP measurement before its clinical utility in the population of interest can be assessed fully.

View Article: PubMed Central - PubMed

Affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

ABSTRACT

Background: Atrial fibrillation (AF) affects around 2% of the population and early detection is beneficial, allowing patients to begin potentially life-saving anticoagulant therapies. Blood pressure (BP) monitors may offer an opportunity to screen for AF.

Aim: To identify and appraise studies which report the diagnostic accuracy of automated BP monitors used for opportunistic AF detection.

Methods: A systematic search was performed of the MEDLINE, MEDLINE In-Process and EMBASE literature databases. Papers were eligible if they described primary studies of the evaluation of a BP device for AF detection, were published in a peer-reviewed journal and reported values for the sensitivity and specificity. Included studies were appraised using the QUADAS-2 tool to assess their risk of bias and applicability to opportunistic AF detection. Values for the sensitivity and specificity of AF detection were extracted from each paper and compared.

Results and conclusions: We identified seven papers evaluating six devices from two manufacturers. Only one study scored low risk in all of the QUADAS-2 domains. All studies reported specificity >85% and 6 reported sensitivity >90%. The studies showed that BP devices with embedded algorithms for detecting arrhythmias show promise as screening tools for AF, comparing favourably with manual pulse palpation. But the studies used different methodologies and many were subject to potential bias. More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during BP measurement before its clinical utility in the population of interest can be assessed fully.

No MeSH data available.


Related in: MedlinePlus

PRISMA diagram showing the results from each stage of the search process. PRISMA, Preferred Reporting Items for Systematic Review and Meta-Analyses.
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OPENHRT2015000362F1: PRISMA diagram showing the results from each stage of the search process. PRISMA, Preferred Reporting Items for Systematic Review and Meta-Analyses.

Mentions: Figure 1 shows the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flow chart depicting the search results at each stage.10 We identified seven papers describing primary studies.11–17 Of these, six were found during the main search; one further paper was published after the search date and was identified by a journal alert using the same search criteria.17 The studies included six devices from two manufacturers. Two of the papers analysed more than one device (table 1).


Opportunistic detection of atrial fibrillation using blood pressure monitors: a systematic review.

Kane SA, Blake JR, McArdle FJ, Langley P, Sims AJ - Open Heart (2016)

PRISMA diagram showing the results from each stage of the search process. PRISMA, Preferred Reporting Items for Systematic Review and Meta-Analyses.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836305&req=5

OPENHRT2015000362F1: PRISMA diagram showing the results from each stage of the search process. PRISMA, Preferred Reporting Items for Systematic Review and Meta-Analyses.
Mentions: Figure 1 shows the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flow chart depicting the search results at each stage.10 We identified seven papers describing primary studies.11–17 Of these, six were found during the main search; one further paper was published after the search date and was identified by a journal alert using the same search criteria.17 The studies included six devices from two manufacturers. Two of the papers analysed more than one device (table 1).

Bottom Line: Values for the sensitivity and specificity of AF detection were extracted from each paper and compared.But the studies used different methodologies and many were subject to potential bias.More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during BP measurement before its clinical utility in the population of interest can be assessed fully.

View Article: PubMed Central - PubMed

Affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.

ABSTRACT

Background: Atrial fibrillation (AF) affects around 2% of the population and early detection is beneficial, allowing patients to begin potentially life-saving anticoagulant therapies. Blood pressure (BP) monitors may offer an opportunity to screen for AF.

Aim: To identify and appraise studies which report the diagnostic accuracy of automated BP monitors used for opportunistic AF detection.

Methods: A systematic search was performed of the MEDLINE, MEDLINE In-Process and EMBASE literature databases. Papers were eligible if they described primary studies of the evaluation of a BP device for AF detection, were published in a peer-reviewed journal and reported values for the sensitivity and specificity. Included studies were appraised using the QUADAS-2 tool to assess their risk of bias and applicability to opportunistic AF detection. Values for the sensitivity and specificity of AF detection were extracted from each paper and compared.

Results and conclusions: We identified seven papers evaluating six devices from two manufacturers. Only one study scored low risk in all of the QUADAS-2 domains. All studies reported specificity >85% and 6 reported sensitivity >90%. The studies showed that BP devices with embedded algorithms for detecting arrhythmias show promise as screening tools for AF, comparing favourably with manual pulse palpation. But the studies used different methodologies and many were subject to potential bias. More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during BP measurement before its clinical utility in the population of interest can be assessed fully.

No MeSH data available.


Related in: MedlinePlus