Prediction models for atrial fibrillation applicable in the community : a systematic review and meta-analysis
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com..
AIMS: Atrial fibrillation (AF) is a common arrhythmia associated with an increased stroke risk. The use of multivariable prediction models could result in more efficient primary AF screening by selecting at-risk individuals. We aimed to determine which model may be best suitable for increasing efficiency of future primary AF screening efforts.
METHODS AND RESULTS: We performed a systematic review on multivariable models derived, validated, and/or augmented for AF prediction in community cohorts using Pubmed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) through 1 August 2019. We performed meta-analysis of model discrimination with the summary C-statistic as the primary expression of associations using a random effects model. In case of high heterogeneity, we calculated a 95% prediction interval. We used the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) checklist for risk of bias assessment. We included 27 studies with a total of 2 978 659 unique participants among 20 cohorts with mean age ranging from 42 to 76 years. We identified 21 risk models used for incident AF risk in community cohorts. Three models showed significant summary discrimination despite high heterogeneity: CHARGE-AF (Cohorts for Heart and Aging Research in Genomic Epidemiology) [summary C-statistic 0.71; 95% confidence interval (95% CI) 0.66-0.76], FHS-AF (Framingham Heart Study risk score for AF) (summary C-statistic 0.70; 95% CI 0.64-0.76), and CHA2DS2-VASc (summary C-statistic 0.69; 95% CI 0.64-0.74). Of these, CHARGE-AF and FHS-AF had originally been derived for AF incidence prediction. Only CHARGE-AF, which comprises easily obtainable measurements and medical history elements, showed significant summary discrimination among cohorts that had applied a uniform (5-year) risk prediction window.
CONCLUSION: CHARGE-AF appeared most suitable for primary screening purposes in terms of performance and applicability in older community cohorts of predominantly European descent.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
|---|---|
| Enthalten in: |
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 - 22(2020), 5 vom: 01. Mai, Seite 684-694 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Himmelreich, Jelle C L [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Atrial fibrillation |
|---|
| Anmerkungen: |
Date Completed 25.06.2021 Date Revised 25.06.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/europace/euaa005 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM306072904 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM306072904 | ||
| 003 | DE-627 | ||
| 005 | 20231225122547.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/europace/euaa005 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1020.xml |
| 035 | |a (DE-627)NLM306072904 | ||
| 035 | |a (NLM)32011689 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Himmelreich, Jelle C L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prediction models for atrial fibrillation applicable in the community |b a systematic review and meta-analysis |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.06.2021 | ||
| 500 | |a Date Revised 25.06.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: Atrial fibrillation (AF) is a common arrhythmia associated with an increased stroke risk. The use of multivariable prediction models could result in more efficient primary AF screening by selecting at-risk individuals. We aimed to determine which model may be best suitable for increasing efficiency of future primary AF screening efforts | ||
| 520 | |a METHODS AND RESULTS: We performed a systematic review on multivariable models derived, validated, and/or augmented for AF prediction in community cohorts using Pubmed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) through 1 August 2019. We performed meta-analysis of model discrimination with the summary C-statistic as the primary expression of associations using a random effects model. In case of high heterogeneity, we calculated a 95% prediction interval. We used the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) checklist for risk of bias assessment. We included 27 studies with a total of 2 978 659 unique participants among 20 cohorts with mean age ranging from 42 to 76 years. We identified 21 risk models used for incident AF risk in community cohorts. Three models showed significant summary discrimination despite high heterogeneity: CHARGE-AF (Cohorts for Heart and Aging Research in Genomic Epidemiology) [summary C-statistic 0.71; 95% confidence interval (95% CI) 0.66-0.76], FHS-AF (Framingham Heart Study risk score for AF) (summary C-statistic 0.70; 95% CI 0.64-0.76), and CHA2DS2-VASc (summary C-statistic 0.69; 95% CI 0.64-0.74). Of these, CHARGE-AF and FHS-AF had originally been derived for AF incidence prediction. Only CHARGE-AF, which comprises easily obtainable measurements and medical history elements, showed significant summary discrimination among cohorts that had applied a uniform (5-year) risk prediction window | ||
| 520 | |a CONCLUSION: CHARGE-AF appeared most suitable for primary screening purposes in terms of performance and applicability in older community cohorts of predominantly European descent | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Community | |
| 650 | 4 | |a Meta-analysis | |
| 650 | 4 | |a Risk model | |
| 650 | 4 | |a Screening | |
| 650 | 4 | |a Systematic review | |
| 700 | 1 | |a Veelers, Lieke |e verfasserin |4 aut | |
| 700 | 1 | |a Lucassen, Wim A M |e verfasserin |4 aut | |
| 700 | 1 | |a Schnabel, Renate B |e verfasserin |4 aut | |
| 700 | 1 | |a Rienstra, Michiel |e verfasserin |4 aut | |
| 700 | 1 | |a van Weert, Henk C P M |e verfasserin |4 aut | |
| 700 | 1 | |a Harskamp, Ralf E |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t 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 |d 1999 |g 22(2020), 5 vom: 01. Mai, Seite 684-694 |w (DE-627)NLM111066492 |x 1532-2092 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2020 |g number:5 |g day:01 |g month:05 |g pages:684-694 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/europace/euaa005 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2020 |e 5 |b 01 |c 05 |h 684-694 | ||