Evidence map›Paper›PMID 38718097›Full record

ArticlePloS one2024

Diagnostic accuracy of digital technologies compared with 12-lead ECG in the diagnosis of atrial fibrillation in adults: A protocol for a systematic review.

Vethanayagam Antony Sheron, Rajendra Surenthirakumaran, Tiffany E Gooden, Gregory Y H Lip, G Neil Thomas, David J Moore, Krishnarajah Nirantharakumar, Balachandran Kumarendran, Kumaran Subaschandran, Shribavan Kanesamoorthy and 3 more

Abstract readComparative Study
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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.

Vethanayagam Antony SheronFaculty of Medicine, Department of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.ORCID https://orcid.org/0000-0002-4848-3238
Rajendra SurenthirakumaranFaculty of Medicine, Department of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.ORCID https://orcid.org/0000-0001-8252-8076
Tiffany E GoodenInstitute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
Gregory Y H LipInstitute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
G Neil ThomasInstitute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
David J MooreInstitute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
Krishnarajah NirantharakumarInstitute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
Balachandran KumarendranFaculty of Medicine, Department of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.ORCID https://orcid.org/0000-0001-7786-5932
Kumaran SubaschandranFaculty of Medicine, Department of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.
Shribavan KanesamoorthyFaculty of Medicine, Department of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.
Powsiga UruthirakumarFaculty of Medicine, Department of Community and Family Medicine, University of Jaffna, Jaffna, Sri Lanka.
Mahesan GuruparanDepartment of Cardiology, Teaching Hospital, Jaffna, Sri Lanka.
NIHR Global Health Research Group on Atrial Fibrillation Management

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the world. AF increases the risk of stroke 5-fold, though the risk can be reduced with appropriate treatment. Therefore, early diagnosis is imperative but remains a global challenge. In low-and middle-income countries (LMICs), a lack of diagnostic equipment and under-resourced healthcare systems generate further barriers. The rapid development of digital technologies that are capable of diagnosing AF remotely and cost-effectively could prove beneficial for LMICs. However, evidence is lacking on what digital technologies exist and how they compare in regards to diagnostic accuracy. We aim to systematically review the diagnostic accuracy of all digital technologies capable of AF diagnosis.

methodsMEDLINE, Embase and Web of Science will be searched for eligible studies. Free text terms will be combined with corresponding index terms where available and searches will not be limited by language nor time of publication. Cohort or cross-sectional studies comprising adult (≥18 years) participants will be included. Only studies that use a 12-lead ECG as the reference test (comparator) and report outcomes of sensitivity, specificity, the diagnostic odds ratio (DOR) or the positive and negative predictive value (PPV and NPV) will be included (or if they provide sufficient data to calculate these outcomes). Two reviewers will independently assess articles for inclusion, extract data using a piloted tool and assess risk of bias using the QUADAS-2 tool. The feasibility of a meta-analysis will be determined by assessing heterogeneity across the studies, grouped by index device, diagnostic threshold and setting. If a meta-analysis is feasible for any index device, pooled sensitivity and specificity will be calculated using a random effect model and presented in forest plots. DISCUSSION: The findings of our review will provide a comprehensive synthesis of the diagnostic accuracy of available digital technologies capable for diagnosing AF. Thus, this review will aid in the identification of which devices could be further trialed and implemented, particularly in a LMIC setting, to improve the early diagnosis of AF.

trial registrationSystematic review registration: PROSPERO registration number is CRD42021290542. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290542.

Indexed as

Atrial FibrillationElectrocardiographySystematic Reviews as TopicAdultDigital TechnologyHumansSensitivity and Specificity

Identifiers

PMID38718097
PMCPMC11078345

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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.