Diagnostic accuracies of screening for atrial fibrillation by cardiac nurses versus radiographers

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Diagnostic accuracies of screening for atrial fibrillation by cardiac nurses versus radiographers. / Kvist, Lærke Marius; Vinter, Nicklas; Urbonaviciene, Grazina; Lindholt, Jes Sanddal; Diederichsen, Axel Cosmus Pyndt; Frost, Lars.

In: Open Heart, Vol. 6, No. 1, e000942, 2019.

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@article{21a4227937ff4f97b79aed88109300aa,
title = "Diagnostic accuracies of screening for atrial fibrillation by cardiac nurses versus radiographers",
abstract = "Aim We examined the diagnostic accuracy of single-lead ECG as assessed by radiographers and 12-lead ECG as assessed by cardiac nurses for the diagnosis of atrial fibrillation (AF). Methods Based on the Danish Cardiovascular Screening Trial, we conducted a population-based, cross-sectional study of 1338 randomly selected Danish men aged 65-74 years with no exclusion criteria. The participants were screened with single-lead ECG during a CT scan assessed by radiographers and 12-lead ECG assessed by cardiac nurses. The diagnostic accuracy was evaluated compared with that produced by a 12-lead ECG assessed by two consenting cardiologists. Results The study identified 68 participants with ongoing AF, of whom 60 had self-reported AF and 8 had AF detected in the screening. Single-lead ECG assessed for AF by radiographers had a sensitivity of 60.3% (95% CI 47.7 to 72.0), specificity of 97.2% (95% CI 96.2 to 98.1), positive predictive value (PPV) of 53.9% (95% CI 42.1 to 65.5) and negative predictive value (NPV) of 97.9% (95% CI 96.9 to 98.6). 12-lead ECG assessed by cardiac nurses had a sensitivity of 97.1% (95% CI 89.8 to 99.6), specificity of 100% (95% CI 99.7 to 100), PPV of 100% (95% CI 94.6 to 100) and NPV of 99.8% (95% CI 99.4 to 100). Conclusions Single-lead ECG assessed by radiographers had a moderate sensitivity and PPV but a very high specificity and NPV. Using radiographers may be acceptable for opportunistic screening, in particular if radiographers are thoroughly trained. Thus, 12-lead ECG assessed by cardiac nurses is a potential diagnostic method for the detection of AF.",
keywords = "atrial fibrillation, diagnostic accuracy, electrocardiography, screening",
author = "Kvist, {L{\ae}rke Marius} and Nicklas Vinter and Grazina Urbonaviciene and Lindholt, {Jes Sanddal} and Diederichsen, {Axel Cosmus Pyndt} and Lars Frost",
year = "2019",
doi = "10.1136/openhrt-2018-000942",
language = "English",
volume = "6",
journal = "Open Heart",
issn = "2398-595X",
publisher = "BMJ",
number = "1",

}

RIS

TY - JOUR

T1 - Diagnostic accuracies of screening for atrial fibrillation by cardiac nurses versus radiographers

AU - Kvist, Lærke Marius

AU - Vinter, Nicklas

AU - Urbonaviciene, Grazina

AU - Lindholt, Jes Sanddal

AU - Diederichsen, Axel Cosmus Pyndt

AU - Frost, Lars

PY - 2019

Y1 - 2019

N2 - Aim We examined the diagnostic accuracy of single-lead ECG as assessed by radiographers and 12-lead ECG as assessed by cardiac nurses for the diagnosis of atrial fibrillation (AF). Methods Based on the Danish Cardiovascular Screening Trial, we conducted a population-based, cross-sectional study of 1338 randomly selected Danish men aged 65-74 years with no exclusion criteria. The participants were screened with single-lead ECG during a CT scan assessed by radiographers and 12-lead ECG assessed by cardiac nurses. The diagnostic accuracy was evaluated compared with that produced by a 12-lead ECG assessed by two consenting cardiologists. Results The study identified 68 participants with ongoing AF, of whom 60 had self-reported AF and 8 had AF detected in the screening. Single-lead ECG assessed for AF by radiographers had a sensitivity of 60.3% (95% CI 47.7 to 72.0), specificity of 97.2% (95% CI 96.2 to 98.1), positive predictive value (PPV) of 53.9% (95% CI 42.1 to 65.5) and negative predictive value (NPV) of 97.9% (95% CI 96.9 to 98.6). 12-lead ECG assessed by cardiac nurses had a sensitivity of 97.1% (95% CI 89.8 to 99.6), specificity of 100% (95% CI 99.7 to 100), PPV of 100% (95% CI 94.6 to 100) and NPV of 99.8% (95% CI 99.4 to 100). Conclusions Single-lead ECG assessed by radiographers had a moderate sensitivity and PPV but a very high specificity and NPV. Using radiographers may be acceptable for opportunistic screening, in particular if radiographers are thoroughly trained. Thus, 12-lead ECG assessed by cardiac nurses is a potential diagnostic method for the detection of AF.

AB - Aim We examined the diagnostic accuracy of single-lead ECG as assessed by radiographers and 12-lead ECG as assessed by cardiac nurses for the diagnosis of atrial fibrillation (AF). Methods Based on the Danish Cardiovascular Screening Trial, we conducted a population-based, cross-sectional study of 1338 randomly selected Danish men aged 65-74 years with no exclusion criteria. The participants were screened with single-lead ECG during a CT scan assessed by radiographers and 12-lead ECG assessed by cardiac nurses. The diagnostic accuracy was evaluated compared with that produced by a 12-lead ECG assessed by two consenting cardiologists. Results The study identified 68 participants with ongoing AF, of whom 60 had self-reported AF and 8 had AF detected in the screening. Single-lead ECG assessed for AF by radiographers had a sensitivity of 60.3% (95% CI 47.7 to 72.0), specificity of 97.2% (95% CI 96.2 to 98.1), positive predictive value (PPV) of 53.9% (95% CI 42.1 to 65.5) and negative predictive value (NPV) of 97.9% (95% CI 96.9 to 98.6). 12-lead ECG assessed by cardiac nurses had a sensitivity of 97.1% (95% CI 89.8 to 99.6), specificity of 100% (95% CI 99.7 to 100), PPV of 100% (95% CI 94.6 to 100) and NPV of 99.8% (95% CI 99.4 to 100). Conclusions Single-lead ECG assessed by radiographers had a moderate sensitivity and PPV but a very high specificity and NPV. Using radiographers may be acceptable for opportunistic screening, in particular if radiographers are thoroughly trained. Thus, 12-lead ECG assessed by cardiac nurses is a potential diagnostic method for the detection of AF.

KW - atrial fibrillation

KW - diagnostic accuracy

KW - electrocardiography

KW - screening

UR - http://www.scopus.com/inward/record.url?scp=85062402340&partnerID=8YFLogxK

U2 - 10.1136/openhrt-2018-000942

DO - 10.1136/openhrt-2018-000942

M3 - Journal article

C2 - 30997131

AN - SCOPUS:85062402340

VL - 6

JO - Open Heart

JF - Open Heart

SN - 2398-595X

IS - 1

M1 - e000942

ER -