Giskes Katrina, Lowres Nicole, Li Jialin, Orchard Jessica, Hespe Charlotte, Freedman Ben
Department of General Practice, School of Medicine, University of Notre Dame, Sydney, Australia.
Sydney Medical School and Charles Perkins Centre, University of Sydney, Sydney, Australia.
Int J Cardiol Heart Vasc. 2020 Dec 16;32:100683. doi: 10.1016/j.ijcha.2020.100683. eCollection 2021 Feb.
Opportunistic screening for silent atrial fibrillation (AF) is recommended to reduce stroke, but screening rates are sub-optimal in general practice. We hypothesize that patient self-screening in the waiting room may improve screening and detection of AF.
This proof-of-concept study tests a purpose-designed AF self-screening station and customised software which seamlessly integrates with general practice electronic medical records and workflow. The self-screening station records a lead-1 ECG. The software automatically (1) identifies eligible patients (aged ≥65 years, no AF diagnosis) from the practice appointment diary; (2) sends eligible patients an automated SMS reminder prior to their appointment; (3) creates individualised QR code to scan at self-screening station; and (4) imports the ECG and result directly into the patients' electronic medical record. Between 5 and 8 general practices in New South Wales, Australia, will participate with an aim of 1500 patients undertaking self-screening. The main outcome measures will be the proportion of eligible patients that undertook self-screening, incidence of newly-diagnosed AF, and patient and staff experience of the self-screening process. De-identified data will be collected using a clinical audit tool, and qualitative interviews will determine patient and staff acceptability.
Ethics approval was received from the University of Sydney Human Research Ethics Committee in June 2019 (Project no: 2019/382) and the University of Notre Dame Human Research Ethics Committee (Project no: 019145S) in October 2019. Results will be disseminated through various forums, including peer-reviewed publication and conference presentations.ACTRN12620000233921.
推荐进行隐匿性房颤（AF）的机会性筛查以降低中风风险，但在全科医疗中筛查率并不理想。我们假设在候诊室进行患者自我筛查可能会改善房颤的筛查和检测。
这项概念验证研究测试了一个专门设计的房颤自我筛查站和定制软件，该软件可与全科医疗电子病历及工作流程无缝集成。自我筛查站记录I导联心电图。该软件会自动：（1）从诊所预约日志中识别符合条件的患者（年龄≥65岁，无房颤诊断）；（2）在预约前向符合条件的患者发送自动短信提醒；（3）生成个性化二维码以便在自我筛查站扫描；（4）将心电图及结果直接导入患者电子病历。澳大利亚新南威尔士州的5至8家全科诊所将参与，目标是1500名患者进行自我筛查。主要结局指标将是进行自我筛查的符合条件患者的比例、新诊断房颤的发生率以及患者和工作人员对自我筛查过程的体验。将使用临床审计工具收集去识别化数据，并通过定性访谈确定患者和工作人员的可接受性。
2019年6月获得悉尼大学人类研究伦理委员会（项目编号：2019/382）以及2019年10月获得圣母大学人类研究伦理委员会（项目编号：019145S）的伦理批准。研究结果将通过各种论坛进行传播，包括同行评审出版物和会议报告。澳大利亚新西兰临床试验注册中心编号：12620000233921。
