Evidence map›Paper›PMID 26464292›Full record

SynthesisEuropean journal of preventive cardiology2016

Accuracy of methods for detecting an irregular pulse and suspected atrial fibrillation: A systematic review and meta-analysis.

Jaspal S Taggar, Tim Coleman, Sarah Lewis, Carl Heneghan, Matthew Jones

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of preventive cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 6 pooled it
6.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 108 citations in OpenAlex.

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  6. Atencion primaria · 2018
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  8. Atrial fibrillation trial to evaluate real-world procedures for their utility in helping to lower stroke events: A randomized clinical trial.International journal of stroke : official journal of the International Stroke Society · 2021
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  9. Opportunistic screening versus usual care for diagnosing atrial fibrillation in general practice: a cluster randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Jaspal S TaggarDivision of Primary Care, University of Nottingham, UK Jaspal.taggar@nottingham.ac.uk.
Tim ColemanDivision of Primary Care, University of Nottingham, UK.
Sarah LewisDivision of Epidemiology and Public Health, University of Nottingham, UK.
Carl HeneghanCentre for Evidence-Based Medicine, University of Oxford, UK.
Matthew JonesDivision of Primary Care, University of Nottingham, UK.
University of Nottingham · GBUniversity of Oxford · GB

Funding

Medical Research Council MR/K023195/1
6 · The paper itself

Abstract

backgroundPulse palpation has been recommended as the first step of screening to detect atrial fibrillation. We aimed to determine and compare the accuracy of different methods for detecting pulse irregularities caused by atrial fibrillation.

methodsWe systematically searched MEDLINE, EMBASE, CINAHL and LILACS until 16 March 2015. Two reviewers identified eligible studies, extracted data and appraised quality using the QUADAS-2 instrument. Meta-analysis, using the bivariate hierarchical random effects method, determined average operating points for sensitivities, specificities, positive and negative likelihood ratios (PLR, NLR); we constructed summary receiver operating characteristic plots.

resultsTwenty-one studies investigated 39 interventions (n = 15,129 pulse assessments) for detecting atrial fibrillation. Compared to 12-lead electrocardiography (ECG) diagnosed atrial fibrillation, blood pressure monitors (BPMs; seven interventions) and non-12-lead ECGs (20 interventions) had the greatest accuracy for detecting pulse irregularities attributable to atrial fibrillation (BPM: sensitivity 0.98 (95% confidence interval (CI) 0.92-1.00), specificity 0.92 (95% CI 0.88-0.95), PLR 12.1 (95% CI 8.2-17.8) and NLR 0.02 (95% CI 0.00-0.09); non-12-lead ECG: sensitivity 0.91 (95% CI 0.86-0.94), specificity 0.95 (95% CI 0.92-0.97), PLR 20.1 (95% CI 12-33.7), NLR 0.09 (95% CI 0.06-0.14)). There were similar findings for smartphone applications (six interventions) although these studies were small in size. The sensitivity and specificity of pulse palpation (six interventions) were 0.92 (95% CI 0.85-0.96) and 0.82 (95% CI 0.76-0.88), respectively (PLR 5.2 (95% CI 3.8-7.2), NLR 0.1 (95% CI 0.05-0.18)).

conclusionsBPMs and non-12-lead ECG were most accurate for detecting pulse irregularities caused by atrial fibrillation; other technologies may therefore be pragmatic alternatives to pulse palpation for the first step of atrial fibrillation screening.

Indexed as

Atrial FibrillationElectrocardiographyHeart RateHumansPalpationROC CurveAtrial fibrillationdiagnostic accuracyirregular pulsescreening

Identifiers

PMID26464292
PMCPMC4952027
OpenAlexW2175171408

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.