Evidence map›Paper›PMID 35103614›Full record

ArticleJMIR research protocols2022

Patient-Led Mass Screening for Atrial Fibrillation in the Older Population Using Handheld Electrocardiographic Devices Integrated With a Clinician-Coordinated Remote Central Monitoring System: Protocol for a Randomized Controlled Trial and Process Evaluation.

Kam Cheong Wong, Tu N Nguyen, Simone Marschner, Samual Turnbull, Mason Jenner Burns, Jia Yi Anna Ne, Vishal Gopal, Anupama Balasuriya Indrawansa, Steven A Trankle, Tim Usherwood and 3 more

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

Article in JMIR research protocols, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
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

13 authors at 2 institutions in 1 country.

Kam Cheong WongWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0003-1898-7678
Tu N NguyenWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-8836-8920
Simone MarschnerWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-5484-9144
Samual TurnbullWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-6328-6689
Mason Jenner BurnsWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0001-6556-7911
Jia Yi Anna NeWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0003-3154-5460
Vishal GopalWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-6468-6254
Anupama Balasuriya IndrawansaWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-6377-1449
Steven A TrankleGeneral Practice Department, School of Medicine, Western Sydney University, Campbelltown, Australia.ORCID https://orcid.org/0000-0002-7131-8361
Tim UsherwoodWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-7522-0345
Saurabh KumarWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-5643-5076
Richard I LindleyWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0002-0104-5679
Clara K ChowWestmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.ORCID https://orcid.org/0000-0003-4693-0038
The University of Sydney · AUCamden and Campbelltown Hospitals · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is common in older people and increases the risk of stroke. The feasibility and effectiveness of the implementation of a patient-led AF screening program for older people are unknown.

objectiveThis study aims to examine the feasibility and effectiveness of an AF screening program comprising patient-led monitoring of single-lead electrocardiograms (ECGs) with clinician-coordinated central monitoring to diagnose AF among community-dwelling people aged ≥75 years in Australia.

methodsThis is a nationwide randomized controlled implementation trial conducted via the internet and remotely among 200 community-dwelling adults aged ≥75 years with no known AF. Randomization will be performed in a 1:1 allocation ratio for the intervention versus control. Intervention group participants will be enrolled in the monitoring program at randomization. They will receive a handheld single-lead ECG device and training on the self-recording of ECGs on weekdays and submit their ECGs via their smartphones. The control group participants will receive usual care from their general practitioners for the initial 6 months and then commence the 6-month monitoring program. The ECGs will be reviewed centrally by trained personnel. Participants and their general practitioners will be notified of AF and other clinically significant ECG abnormalities.

resultsThis study will establish the feasibility and effectiveness of implementing the intervention in this patient population. The primary clinical outcome is the AF detection rate, and the primary feasibility outcome is the patient satisfaction score. Other outcomes include appropriate use of anticoagulant therapy, participant recruitment rate, program engagement (eg, frequency of ECG transmission), agreement in ECG interpretation between the device automatic algorithm and clinicians, the proportion of participants who complete the trial and number of dropouts, and the impact of frailty on feasibility and outcomes. We will conduct a qualitative evaluation to examine the barriers to and acceptability and enablers of implementation. Ethics approval was obtained from the human research ethics committee at the University of Sydney (project number 2020/680). The results will be disseminated via conventional scientific forums, including peer-reviewed publications and presentations at national and international conferences.

conclusionsBy incorporating an integrated health care approach involving patient empowerment, centralized clinician-coordinated ECG monitoring, and facilitation of primary care and specialist services, it is possible to diagnose and treat AF early to reduce stroke risk. This study will provide new information on how to implement AF screening using digital health technology practicably and feasibly for older and frail populations residing in the community.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12621000184875; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380877. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34778.

Indexed as

acceptabilityagingatrial fibrillationbarriercardiologycardiovascularECGeffectivenesselderlyelectrocardiogramenablerfeasibilityhandheldheart diseaseimplementationmobile phonemonitoringolder adultsscreeninguser experienceuser perception

Identifiers

PMID35103614
PMCPMC8848249
OpenAlexW4210640800

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.