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• W2654908526 abstract "Background Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. Objectives To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model. Design Systematic review, meta-analysis and cost-effectiveness analysis. Setting Primary care. Participants Adults. Intervention Screening strategies, defined by screening test, age at initial and final screens, screening interval and format of screening {systematic opportunistic screening [individuals offered screening if they consult with their general practitioner (GP)] or systematic population screening (when all eligible individuals are invited to screening)}. Main outcome measures Sensitivity, specificity and diagnostic odds ratios; the odds ratio of detecting new AF cases compared with no screening; and the mean incremental net benefit compared with no screening. Review methods Two reviewers screened the search results, extracted data and assessed the risk of bias. A DTA meta-analysis was perfomed, and a decision tree and Markov model was used to evaluate the cost-effectiveness of the screening strategies. Results Diagnostic test accuracy depended on the screening test and how it was interpreted. In general, the screening tests identified in our review had high sensitivity (> 0.9). Systematic population and systematic opportunistic screening strategies were found to be similarly effective, with an estimated 170 individuals needed to be screened to detect one additional AF case compared with no screening. Systematic opportunistic screening was more likely to be cost-effective than systematic population screening, as long as the uptake of opportunistic screening observed in randomised controlled trials translates to practice. Modified blood pressure monitors, photoplethysmography or nurse pulse palpation were more likely to be cost-effective than other screening tests. A screening strategy with an initial screening age of 65 years and repeated screens every 5 years until age 80 years was likely to be cost-effective, provided that compliance with treatment does not decline with increasing age. Conclusions A national screening programme for AF is likely to represent a cost-effective use of resources. Systematic opportunistic screening is more likely to be cost-effective than systematic population screening. Nurse pulse palpation or modified blood pressure monitors would be appropriate screening tests, with confirmation by diagnostic 12-lead electrocardiography interpreted by a trained GP, with referral to a specialist in the case of an unclear diagnosis. Implementation strategies to operationalise uptake of systematic opportunistic screening in primary care should accompany any screening recommendations. Limitations Many inputs for the economic model relied on a single trial [the Screening for Atrial Fibrillation in the Elderly (SAFE) study] and DTA results were based on a few studies at high risk of bias/of low applicability. Future work Comparative studies measuring long-term outcomes of screening strategies and DTA studies for new, emerging technologies and to replicate the results for photoplethysmography and GP interpretation of 12-lead electrocardiography in a screening population. Study registration This study is registered as PROSPERO CRD42014013739. Funding The National Institute for Health Research Health Technology Assessment programme." @default.
• W2654908526 created "2017-06-30" @default.
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• W2654908526 date "2017-05-01" @default.
• W2654908526 modified "2023-10-01" @default.
• W2654908526 title "Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis" @default.
• W2654908526 cites W107386444 @default.
• W2654908526 cites W108653819 @default.
• W2654908526 cites W1496114842 @default.
• W2654908526 cites W1537181695 @default.
• W2654908526 cites W1538696700 @default.
• W2654908526 cites W1543312551 @default.
• W2654908526 cites W1583458225 @default.
• W2654908526 cites W1599745729 @default.
• W2654908526 cites W1614663039 @default.
• W2654908526 cites W1616073113 @default.
• W2654908526 cites W1747765887 @default.
• W2654908526 cites W1904044631 @default.
• W2654908526 cites W1912202071 @default.
• W2654908526 cites W1924098982 @default.
• W2654908526 cites W1944792747 @default.
• W2654908526 cites W1952995987 @default.
• W2654908526 cites W1964305111 @default.
• W2654908526 cites W1965248334 @default.
• W2654908526 cites W1965474377 @default.
• W2654908526 cites W1966150055 @default.
• W2654908526 cites W1966976606 @default.
• W2654908526 cites W1966986942 @default.
• W2654908526 cites W1969354095 @default.
• W2654908526 cites W1969934955 @default.
• W2654908526 cites W1969977872 @default.
• W2654908526 cites W1971883246 @default.
• W2654908526 cites W1972382025 @default.
• W2654908526 cites W1973117966 @default.
• W2654908526 cites W1973130803 @default.
• W2654908526 cites W1973720787 @default.
• W2654908526 cites W1974073351 @default.
• W2654908526 cites W1976131663 @default.
• W2654908526 cites W1977819036 @default.
• W2654908526 cites W1978973649 @default.
• W2654908526 cites W1979295509 @default.
• W2654908526 cites W1979686062 @default.
• W2654908526 cites W1980546099 @default.
• W2654908526 cites W1981594654 @default.
• W2654908526 cites W1982692087 @default.
• W2654908526 cites W1983094580 @default.
• W2654908526 cites W1983100643 @default.
• W2654908526 cites W1984483079 @default.
• W2654908526 cites W1985124762 @default.
• W2654908526 cites W1985949193 @default.
• W2654908526 cites W1986301494 @default.
• W2654908526 cites W1987581560 @default.
• W2654908526 cites W1989156452 @default.
• W2654908526 cites W1990322388 @default.
• W2654908526 cites W1990479281 @default.
• W2654908526 cites W1991360393 @default.
• W2654908526 cites W1991772559 @default.
• W2654908526 cites W1991931656 @default.
• W2654908526 cites W1992881033 @default.
• W2654908526 cites W1993346928 @default.
• W2654908526 cites W1993723007 @default.
• W2654908526 cites W1994902122 @default.
• W2654908526 cites W1997219648 @default.
• W2654908526 cites W1997989037 @default.
• W2654908526 cites W1998467777 @default.
• W2654908526 cites W2000820525 @default.
• W2654908526 cites W2001207354 @default.
• W2654908526 cites W2002614646 @default.
• W2654908526 cites W2002973062 @default.
• W2654908526 cites W2004729966 @default.
• W2654908526 cites W2005057889 @default.
• W2654908526 cites W2005547218 @default.
• W2654908526 cites W2008666333 @default.
• W2654908526 cites W2009246893 @default.
• W2654908526 cites W2009256127 @default.
• W2654908526 cites W2010355864 @default.
• W2654908526 cites W2011839610 @default.
• W2654908526 cites W2013697141 @default.
• W2654908526 cites W2015960591 @default.
• W2654908526 cites W2016423916 @default.
• W2654908526 cites W2018384173 @default.
• W2654908526 cites W2018796325 @default.
• W2654908526 cites W2019078790 @default.

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