Identification of undiagnosed atrial fibrillation patients using a machine learning risk prediction algorithm and diagnostic testing (PULsE-AI) : Study protocol for a randomised controlled trial
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved..
Atrial fibrillation (AF) is associated with an increased risk of stroke, enhanced stroke severity, and other comorbidities. However, AF is often asymptomatic, and frequently remains undiagnosed until complications occur. Current screening approaches for AF lack either cost-effectiveness or diagnostic sensitivity; thus, there is interest in tools that could be used for population screening. An AF risk prediction algorithm, developed using machine learning from a UK dataset of 2,994,837 patients, was found to be more effective than existing models at identifying patients at risk of AF. Therefore, the aim of the trial is to assess the effectiveness of this risk prediction algorithm combined with diagnostic testing for the identification of AF in a real-world primary care setting. Eligible participants (aged ≥30 years and without an existing AF diagnosis) registered at participating UK general practices will be randomised into intervention and control arms. Intervention arm participants identified at highest risk of developing AF (algorithm risk score ≥ 7.4%) will be invited for a 12‑lead electrocardiogram (ECG) followed by two-weeks of home-based ECG monitoring with a KardiaMobile device. Control arm participants will be used for comparison and will be managed routinely. The primary outcome is the number of AF diagnoses in the intervention arm compared with the control arm during the research window. If the trial is successful, there is potential for the risk prediction algorithm to be implemented throughout primary care for narrowing the population considered at highest risk for AF who could benefit from more intensive screening for AF. Trial Registration: NCT04045639.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:99 |
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| Enthalten in: |
Contemporary clinical trials - 99(2020) vom: 01. Dez., Seite 106191 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hill, Nathan R [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial fibrillation |
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| Anmerkungen: |
Date Completed 24.09.2021 Date Revised 16.11.2022 published: Print-Electronic ClinicalTrials.gov: NCT04045639 Citation Status MEDLINE |
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| doi: |
10.1016/j.cct.2020.106191 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM316604933 |
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| 100 | 1 | |a Hill, Nathan R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Identification of undiagnosed atrial fibrillation patients using a machine learning risk prediction algorithm and diagnostic testing (PULsE-AI) |b Study protocol for a randomised controlled trial |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 16.11.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04045639 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Atrial fibrillation (AF) is associated with an increased risk of stroke, enhanced stroke severity, and other comorbidities. However, AF is often asymptomatic, and frequently remains undiagnosed until complications occur. Current screening approaches for AF lack either cost-effectiveness or diagnostic sensitivity; thus, there is interest in tools that could be used for population screening. An AF risk prediction algorithm, developed using machine learning from a UK dataset of 2,994,837 patients, was found to be more effective than existing models at identifying patients at risk of AF. Therefore, the aim of the trial is to assess the effectiveness of this risk prediction algorithm combined with diagnostic testing for the identification of AF in a real-world primary care setting. Eligible participants (aged ≥30 years and without an existing AF diagnosis) registered at participating UK general practices will be randomised into intervention and control arms. Intervention arm participants identified at highest risk of developing AF (algorithm risk score ≥ 7.4%) will be invited for a 12‑lead electrocardiogram (ECG) followed by two-weeks of home-based ECG monitoring with a KardiaMobile device. Control arm participants will be used for comparison and will be managed routinely. The primary outcome is the number of AF diagnoses in the intervention arm compared with the control arm during the research window. If the trial is successful, there is potential for the risk prediction algorithm to be implemented throughout primary care for narrowing the population considered at highest risk for AF who could benefit from more intensive screening for AF. Trial Registration: NCT04045639 | ||
| 650 | 4 | |a Clinical Trial Protocol | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Atrial fibrillation screening | |
| 650 | 4 | |a Machine learning | |
| 650 | 4 | |a Neural networks | |
| 650 | 4 | |a Stroke prevention | |
| 650 | 4 | |a Targeted screening | |
| 700 | 1 | |a Arden, Chris |e verfasserin |4 aut | |
| 700 | 1 | |a Beresford-Hulme, Lee |e verfasserin |4 aut | |
| 700 | 1 | |a Camm, A John |e verfasserin |4 aut | |
| 700 | 1 | |a Clifton, David |e verfasserin |4 aut | |
| 700 | 1 | |a Davies, D Wyn |e verfasserin |4 aut | |
| 700 | 1 | |a Farooqui, Usman |e verfasserin |4 aut | |
| 700 | 1 | |a Gordon, Jason |e verfasserin |4 aut | |
| 700 | 1 | |a Groves, Lara |e verfasserin |4 aut | |
| 700 | 1 | |a Hurst, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Lawton, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Lister, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Mallen, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Martin, Anne-Celine |e verfasserin |4 aut | |
| 700 | 1 | |a McEwan, Phil |e verfasserin |4 aut | |
| 700 | 1 | |a Pollock, Kevin G |e verfasserin |4 aut | |
| 700 | 1 | |a Rogers, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Sandler, Belinda |e verfasserin |4 aut | |
| 700 | 1 | |a Sugrue, Daniel M |e verfasserin |4 aut | |
| 700 | 1 | |a Cohen, Alexander T |e verfasserin |4 aut | |
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