当前位置： SCI文献检索 > BMJ Open期刊下所有文献 > Triage tests for identifying atrial fibrillation in primary care: a diagnostic accuracy study comparing single-lead ECG and modified BP monitors.

Triage tests for identifying atrial fibrillation in primary care: a diagnostic accuracy study comparing single-lead ECG and modified BP monitors.

Abstract：

OBJECTIVE:New electronic devices offer an opportunity within routine primary care settings for improving the detection of atrial fibrillation (AF), which is a common cardiac arrhythmia and a modifiable risk factor for stroke. We aimed to assess the performance of a modified blood pressure (BP) monitor and two single-lead ECG devices, as diagnostic triage tests for the detection of AF. SETTING:6 General Practices in the UK. PARTICIPANTS:1000 ambulatory patients aged 75 years and over. PRIMARY AND SECONDARY OUTCOME MEASURES:Comparative diagnostic accuracy of modified BP monitor and single-lead ECG devices, compared to reference standard of 12-lead ECG, independently interpreted by cardiologists. RESULTS:A total of 79 participants (7.9%) had AF diagnosed by 12-lead ECG. All three devices had a high sensitivity (93.9-98.7%) and are useful for ruling out AF. WatchBP is a better triage test than Omron autoanalysis because it is more specific-89.7% (95% CI 87.5% to 91.6%) compared to 78.3% (95% CI 73.0% to 82.9%), respectively. This would translate into a lower follow-on ECG rate of 17% to rule in/rule out AF compared to 29.7% with the Omron text message in the study population. The overall specificity of single-lead ECGs analysed by a cardiologist was 94.6% for Omron and 90.1% for Merlin. CONCLUSIONS:WatchBP performs better as a triage test for identifying AF in primary care than the single-lead ECG monitors as it does not require expertise for interpretation and its diagnostic performance is comparable to single-lead ECG analysis by cardiologists. It could be used opportunistically to screen elderly patients for undiagnosed AF at regular intervals and/or during BP measurement.

journal_name

BMJ Open

journal_title

BMJ open

authors

Kearley K,Selwood M,Van den Bruel A,Thompson M,Mant D,Hobbs FR,Fitzmaurice D,Heneghan C

doi

10.1136/bmjopen-2013-004565

subject

Has Abstract

pub_date

2014-05-02 00:00:00

pages

e004565

issue

5

issn

2044-6055

pii

bmjopen-2013-004565

journal_volume

4

pub_type

杂志文章

相关文献

BMJ Open文献大全