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Article: Effectiveness of a nongovernmental organization-led large-scale community atrial fibrillation screening program using the smartphone electrocardiogram: An observational cohort study

TitleEffectiveness of a nongovernmental organization-led large-scale community atrial fibrillation screening program using the smartphone electrocardiogram: An observational cohort study
Authors
KeywordsAtrial fibrillation
Nongovernmental organization
Screening
Smartphone electrocardiogram
Stroke
Issue Date2018
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal
Citation
Heart Rhythm, 2018, v. 15 n. 9, p. 1306-1311 How to Cite?
AbstractBackground: Opportunistic screening for atrial fibrillation (AF) in patients older than 65 years is currently recommended. Objective: We aim to examine the effectiveness of a nongovernmental organization–led community-based AF screening program carried out by trained layperson volunteers. Methods: AF screening was performed using a smartphone electrocardiogram in 11,574 participants. Results: Among all participants, smartphone electrocardiograms were interpretable in 10,735 citizens (92.8%; 8564 female citizens [79.8%]; mean age 78.6 ± 8.1 years). Two hundred forty-four participants (2.3%; 95% confidence interval [CI] 2–2.6%; 172 female participants [70.5%]; mean age 79.5 ± 7.9 years) had AF and were advised over phone by a nurse to seek medical attention. Newly diagnosed AF was found in 74 participants (0.69%; 95% CI 0.54–0.84%) with a mean CHA 2 DS 2 -VASc score of 3.9 ± 1.5. Thirty-six of them (48%; 95% CI 36.6–59.4%) were asymptomatic. The number needed to screen for 1 newly diagnosed AF was 145. Telephone follow-up of participants with AF was conducted 9 months after screening. Of 72 participants with newly diagnosed AF and indicated for oral anticoagulation, 47 (65.3%; 95% CI 54.3–76.3%) sought medical attention, 17 (23.6%; 95% CI 13.8–33.4%) received oral anticoagulants, and 16 (22.2%; 95% CI 12.6–31.8%) had 100% compliance. The number needed to screen for 1 appropriately treated newly diagnosed AF was 671. Conclusion: This nongovernmental organization–led community-based AF screening program is effective in identifying citizens with newly diagnosed AF. However, the effectiveness of the program in subsequently leading them to receive appropriate oral anticoagulation therapy is weakened by the lack of a more structured downstream management pathway. © 2018 Heart Rhythm Society
Persistent Identifierhttp://hdl.handle.net/10722/275123
ISSN
2017 Impact Factor: 4.743
2015 SCImago Journal Rankings: 2.756
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, NY-
dc.contributor.authorChoy, CC-
dc.contributor.authorChan, CK-
dc.contributor.authorSiu, DCW-
dc.date.accessioned2019-09-10T02:35:55Z-
dc.date.available2019-09-10T02:35:55Z-
dc.date.issued2018-
dc.identifier.citationHeart Rhythm, 2018, v. 15 n. 9, p. 1306-1311-
dc.identifier.issn1547-5271-
dc.identifier.urihttp://hdl.handle.net/10722/275123-
dc.description.abstractBackground: Opportunistic screening for atrial fibrillation (AF) in patients older than 65 years is currently recommended. Objective: We aim to examine the effectiveness of a nongovernmental organization–led community-based AF screening program carried out by trained layperson volunteers. Methods: AF screening was performed using a smartphone electrocardiogram in 11,574 participants. Results: Among all participants, smartphone electrocardiograms were interpretable in 10,735 citizens (92.8%; 8564 female citizens [79.8%]; mean age 78.6 ± 8.1 years). Two hundred forty-four participants (2.3%; 95% confidence interval [CI] 2–2.6%; 172 female participants [70.5%]; mean age 79.5 ± 7.9 years) had AF and were advised over phone by a nurse to seek medical attention. Newly diagnosed AF was found in 74 participants (0.69%; 95% CI 0.54–0.84%) with a mean CHA 2 DS 2 -VASc score of 3.9 ± 1.5. Thirty-six of them (48%; 95% CI 36.6–59.4%) were asymptomatic. The number needed to screen for 1 newly diagnosed AF was 145. Telephone follow-up of participants with AF was conducted 9 months after screening. Of 72 participants with newly diagnosed AF and indicated for oral anticoagulation, 47 (65.3%; 95% CI 54.3–76.3%) sought medical attention, 17 (23.6%; 95% CI 13.8–33.4%) received oral anticoagulants, and 16 (22.2%; 95% CI 12.6–31.8%) had 100% compliance. The number needed to screen for 1 appropriately treated newly diagnosed AF was 671. Conclusion: This nongovernmental organization–led community-based AF screening program is effective in identifying citizens with newly diagnosed AF. However, the effectiveness of the program in subsequently leading them to receive appropriate oral anticoagulation therapy is weakened by the lack of a more structured downstream management pathway. © 2018 Heart Rhythm Society-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal-
dc.relation.ispartofHeart Rhythm-
dc.subjectAtrial fibrillation-
dc.subjectNongovernmental organization-
dc.subjectScreening-
dc.subjectSmartphone electrocardiogram-
dc.subjectStroke-
dc.titleEffectiveness of a nongovernmental organization-led large-scale community atrial fibrillation screening program using the smartphone electrocardiogram: An observational cohort study-
dc.typeArticle-
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hk-
dc.identifier.authoritySiu, DCW=rp00534-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.hrthm.2018.06.006-
dc.identifier.pmid29890321-
dc.identifier.scopuseid_2-s2.0-85050337188-
dc.identifier.hkuros304675-
dc.identifier.volume15-
dc.identifier.issue9-
dc.identifier.spage1306-
dc.identifier.epage1311-
dc.identifier.isiWOS:000442908500007-
dc.publisher.placeUnited States-

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