Evidence map›Paper›PMID 30385444›Full record

ArticleBMJ open2018

Atrial Fibrillation Screen, Management And Guideline Recommended Therapy (AF SMART II) in the rural primary care setting: an implementation study protocol.

Jessica J Orchard, Lis Neubeck, Ben Freedman, Ruth Webster, Anushka Patel, Robyn Gallagher, Jialin Li, Charlotte Mary Hespe, Caleb Ferguson, Nicholas Zwar and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 12% 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

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 2 countries.

Jessica J OrchardSydney Medical School and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-5702-7277
Lis NeubeckSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.
Ben FreedmanSydney Medical School and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
Ruth WebsterThe George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia.
Anushka PatelThe George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia.
Robyn GallagherSydney Nursing School, University of Sydney, Sydney, New South Wales, Australia.
Jialin LiSydney Nursing School, University of Sydney, Sydney, New South Wales, Australia.
Charlotte Mary HespeGeneral Practice Research, School of Medicine, The University of Notre Dame, Sydney, New South Wales, Australia.
Caleb FergusonWestern Sydney Nursing and Midwifery Centre, Western Sydney University and Western Sydney Local Health District, Sydney, New South Wales, Australia.
Nicholas ZwarSchool of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
Nicole LowresSydney Medical School and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
The University of Sydney · AUUNSW Sydney · AUEdinburgh Napier University · GBSydney Local Health District · AUThe University of Notre Dame Australia · AUUniversity of Wollongong · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionScreening for atrial fibrillation (AF) in people ≥65 years is now recommended by guidelines and expert consensus. While AF is often asymptomatic, it is the most common heart arrhythmia and is associated with increased risk of stroke. Early identification and treatment with oral anticoagulants can substantially reduce stroke risk. The general practice setting is ideal for opportunistic screening and provides a natural pathway for treatment for those identified.This study aims to investigate the feasibility of implementing screening for AF in rural general practice using novel electronic tools. It will assess whether screening will fit within an existing workflow to quickly and accurately identify AF, and will potentially inform a generalisable, scalable approach. METHODS AND ANALYSIS: Screening with a smartphone ECG will be conducted by general practitioners and practice nurses in rural general practices in New South Wales, Australia for 3-4 months during 2018-2019. Up to 10 practices will be recruited, and we aim to screen 2000 patients aged ≥65 years. Practices will be given an electronic screening prompt and electronic decision support to guide evidence-based treatment for those with AF. De-identified data will be collected using a clinical audit tool and qualitative interviews will be conducted with selected practice staff. A process evaluation and cost-effectiveness analysis will also be undertaken. Outcomes include implementation success (proportion of eligible patients screened, fidelity to protocol), proportion of people screened identified with new AF and rates of treatment with anticoagulants and antiplatelets at baseline and completion. Results will be compared against an earlier metropolitan study and a 'control' dataset of practices. ETHICS AND DISSEMINATION: Ethics approval was received from the University of Sydney Human Research Ethics Committee on 27 February 2018 (Project no.: 2017/1017). Results will be disseminated through various forums, including peer-reviewed publication and conference presentations. TRIAL REGISTRATION NUMBER: ACTRN12618000004268; Pre-results.

Indexed as

Primary Health CareRural Health ServicesAgedAtrial FibrillationClinical ProtocolsHumansMass ScreeningMobile ApplicationsSmartphoneatrial fibrillationelectronic decision supportoran anticoagulantsscreening

Identifiers

PMID30385444
PMCPMC6252758
OpenAlexW2898740701

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.