Tang Edmond W L, Yip Benjamin H K, Yu Chun-Pong, Wong Samuel Y S, Lee Eric K P
Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Li Ping Medical Library, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Front Cardiovasc Med. 2022 Aug 12;9:956542. doi: 10.3389/fcvm.2022.956542. eCollection 2022.
Atrial fibrillation (AF) is a prevalent and preventable cause of stroke and mortality.
This systematic review and meta-analysis aimed to investigate the sensitivity and specificity of office and out-of-office automated blood pressure (BP) devices to detect AF.
Diagnostic studies, extracted from databases such as Ovid Medline and Embase, on AF detection by BP device(s), electrocardiography, and reported sensitivity and specificity, were included. Screening of abstracts and full texts, data extraction, and quality assessment were conducted independently by two investigators using Covidence software. The sensitivity and specificity of the BP devices were pooled using a random-effects model.
Sixteen studies including 10,158 participants were included. Only a few studies were conducted in primary care ( = 3) or with a low risk of bias ( = 5). Office BP devices, which utilised different algorithms to detect AF, had a sensitivity and specificity of 96.2 and 94%, respectively. Specificity was reduced when only one positive result was considered among consecutive BP measurements. Only a few studies ( = 3) investigated out-of-office BP. Only one study ( = 100) suggested the use of ≥79 and ≥26% of positive readings on 24-h ambulatory BP measurements to detect AF and paroxysmal AF, respectively.
Office BP devices can be used clinically to screen for AF in high-risk populations. Clinical trials are needed to determine the effect of AF screening using office BP devices in reducing stroke risk and mortality. Further studies are also required to guide out-of-office use of BP devices for detecting paroxysmal AF or AF.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319541, PROSPERO CRD42022319541.
心房颤动（AF）是中风和死亡的常见且可预防的原因。
本系统评价和荟萃分析旨在研究诊室和诊室外自动血压（BP）设备检测AF的敏感性和特异性。
纳入从Ovid Medline和Embase等数据库中提取的关于通过BP设备、心电图检测AF以及报告的敏感性和特异性的诊断研究。两名研究人员使用Covidence软件独立进行摘要和全文筛选、数据提取和质量评估。使用随机效应模型汇总BP设备的敏感性和特异性。
纳入了16项研究，共10158名参与者。只有少数研究在初级保健机构开展（n = 3）或偏倚风险较低（n = 5）。使用不同算法检测AF的诊室BP设备的敏感性和特异性分别为96.2%和94%。当连续BP测量中仅考虑一个阳性结果时，特异性降低。只有少数研究（n = 3）调查了诊室外BP。只有一项研究（n = 100）建议分别使用24小时动态血压测量中≥79%和≥26%的阳性读数来检测AF和阵发性AF。
诊室BP设备可在临床上用于高危人群的AF筛查。需要进行临床试验以确定使用诊室BP设备进行AF筛查对降低中风风险和死亡率的效果。还需要进一步研究以指导诊室外使用BP设备检测阵发性AF或AF。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319541，PROSPERO CRD42022319541。
