Evidence map›Paper›PMID 39237274›Full record

ArticleBMJ open2024

Actioning atrial fibrillation identified by ambulance services in England: a qualitative exploration.

Chris Wilkinson, Susan Moloney, Graham McClelland, Adam Todd, Tim Doran, Christopher Price

Abstract read
In one paragraph

Article in BMJ open, 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. 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

6 authors.

Chris WilkinsonHull York Medical School, University of York, York, UK chris.wilkinson@hyms.ac.uk.ORCID 0000-0003-0748-0150
Susan MoloneyPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Graham McClellandNorth East Ambulance Service NHS Trust, Newcastle Upon Tyne, UK.
Adam ToddSchool of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0003-1496-9341
Tim DoranHealth Sciences, University of York, York, UK.
Christopher PricePopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore the acceptability and feasibility of detection of atrial fibrillation (AF) by emergency medical services (EMS) and identify potential barriers and facilitators to implementing a formal pathway to facilitate follow-up in primary care, which could reduce the risk of AF-related stroke.

designQualitative study using focus groups and one-to-one interviews guided by a semistructured topic guide.

settingNorth East England.

participantsFocus groups with 18 members of the public and one-to-one online interviews with 11 healthcare and service providers (six paramedics and five experts representing cardiology, general practice (GP), public health, research, policy and commissioning).

resultsAll participant groups were supportive of a role of EMS in identifying AF as part of routine assessment and formalising the response to AF detection. However, this should not create delays for EMS since rate-controlled AF is non-urgent and alternative community mechanisms exist to manage it. Public participants were concerned about communication of the AF diagnosis and whether this should be 'on scene' or in a subsequent GP appointment. Paramedics reported frequent incidental identification of AF, but it is not always clear 'on scene' that this is a new diagnosis, and there is variation in practice regarding whether (and how) this is communicated to the GP. Paramedics also focused on ensuring the safety of non-conveyed patients and a perceived need for an 'active' reporting process, so that a finding of AF was actioned. Field experts felt that a formal pathway would be useful and favoured a simple intervention without adding to time pressures unnecessarily.

conclusionsThere is support for the development of a formal pathway to ensure follow-up for people with AF that is incidentally detected by EMS. This has the potential to improve anticoagulation rates and reduce the risk of stroke.

Indexed as

AmbulancesAtrial FibrillationEmergency Medical ServicesFocus GroupsQualitative ResearchAdultAgedAttitude of Health PersonnelEnglandFemaleHumansInterviews as TopicMaleMiddle AgedPrimary Health CareStrokeanticoagulationcardiologypreventive medicinepublic health

Identifiers

PMID39237274
PMCPMC11381708

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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.