Trial reportBMJ (Clinical research ed.)2020
Opportunistic screening versus usual care for detection of atrial fibrillation in primary care: cluster randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
51 citing papers in PubMed, 4 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Opportunistic and systematic screening for atrial fibrillation in adults aged ≥ 65 years in primary care: a systematic review of randomized and cluster randomized trials.BMC cardiovascular disorders · 2026Pooled it
- Screening for Atrial Fibrillation in Stroke Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Reviews in cardiovascular medicine · 2025Pooled it
- Screening strategies for atrial fibrillation in the elderly population: a systematic review and network meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Pooled it
- Sensitivity and specificity of automated blood pressure devices to detect atrial fibrillation: A systematic review and meta-analysis of diagnostic accuracy.Frontiers in cardiovascular medicine · 2022Pooled it
- Systematic, randomized atrial fibrillation screening using detailed phenotyping with a risk prediction model combined with patch electrocardiogram in a Swedish population aged 65 years or older: the CONSIDERING-AF trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Trial
- Identifying a Heterogeneous Effect of Atrial Fibrillation Screening in Older Adults: A Secondary Analysis of the VITAL-AF Trial.Circulation. Cardiovascular quality and outcomes · 2025Trial
- Risk-based screening for the evaluation of atrial fibrillation in general practice (R-BEAT): a randomized cross-over trial.QJM : monthly journal of the Association of Physicians · 2025Trial
- Automated interpretations of single-lead electrocardiograms predict incident atrial fibrillation: The VITAL-AF trial.Heart rhythm · 2024Trial
- Trial
- Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: VITAL-AF Randomized Controlled Trial.Circulation · 2022Trial
- Screening for atrial fibrillation using an ECG monitoring patch among the elderly population in rural China: a single-arm study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Prioritizing Discovery and Advancements in Arrhythmia Therapies: NIH/NHLBI Workshop.JACC. Clinical electrophysiology · 2026Review
- Observational
- Early differentiation between paroxysmal and persistent atrial fibrillation based on interpretable machine learning: a multicenter retrospective study.BioData mining · 2026Article
- Recent-onset atrial fibrillation: challenges and opportunities.European heart journal · 2026Review
- Active Monitoring for AtriaL FIbrillation (AMALFI): Rationale, protocol, and pilot for a pragmatic, randomized, controlled trial of remote screening for asymptomatic atrial fibrillation.American heart journal · 2025Article
- Machine Learning-Based Plasma Protein Risk Score Improves Atrial Fibrillation Prediction Over Clinical and Genomic Models.Circulation. Genomic and precision medicine · 2025Article
- A machine learning-based model for predicting paroxysmal and persistent atrial fibrillation based on EHR.BMC medical informatics and decision making · 2025Observational
- Demystifying AI for early AF detection: enhancing diagnostic transparency across modalities.The British journal of cardiology · 2025Article
- Global implementation and evaluation of atrial fibrillation screening in the past two decades - a narrative review.NPJ cardiovascular health · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether opportunistic screening in primary care increases the detection of atrial fibrillation compared with usual care.
designCluster randomised controlled trial.
setting47 intention-to-screen and 49 usual care primary care practices in the Netherlands, not blinded for allocation; the study was carried out from September 2015 to August 2018.
participantsIn each practice, a fixed sample of 200 eligible patients, aged 65 or older, with no known history of atrial fibrillation in the electronic medical record system, were randomly selected. In the intention-to-screen group, 9218 patients eligible for screening were included, 55.0% women, mean age 75.2 years. In the usual care group, 9526 patients were eligible for screening, 54.3% women, mean age 75.0 years.
interventionsOpportunistic screening (that is, screening in patients visiting their general practice) consisted of three index tests: pulse palpation, electronic blood pressure measurement with an atrial fibrillation algorithm, and electrocardiography (ECG) with a handheld single lead electrocardiographic device. The reference standard was 12 lead ECG, performed in patients with at least one positive index test and in a sample of patients (10%) with three negative tests. If 12 lead ECG showed no atrial fibrillation, patients were invited for more screening by continuous monitoring with a Holter electrocardiograph for two weeks.
main outcome measuresDifference in the detection rate of newly diagnosed atrial fibrillation over one year in intention-to-screen versus usual care practices.
resultsFollow-up was complete for 8874 patients in the intention-to-screen practices and for 9102 patients in the usual care practices. 144 (1.62%) new diagnoses of atrial fibrillation in the intention-to-screen group versus 139 (1.53%) in the usual care group were found (adjusted odds ratio 1.06 (95% confidence interval 0.84 to 1.35)). Of 9218 eligible patients in the intention-to-screen group, 4106 (44.5%) participated in the screening protocol. In these patients, 12 lead ECG detected newly diagnosed atrial fibrillation in 26 patients (0.63%). In the 266 patients who continued with Holter monitoring, four more diagnoses of atrial fibrillation were found.
conclusionsOpportunistic screening for atrial fibrillation in primary care patients, aged 65 and over, did not increase the detection rate of atrial fibrillation, which implies that opportunistic screening for atrial fibrillation is not useful in this setting.
trial registrationNetherlands Trial Register No NL4776 (old NTR4914).
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Registered trials
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.