scholarly journals Systematic review and meta-analysis of pre-hospital diagnostic accuracy studies

2018 ◽  
pp. emermed-2018-207588
Author(s):  
Caitlin Wilson ◽  
Clare Harley ◽  
Stephanie Steels
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Cochrane Database ◽  
Full Text Review ◽  
Registration Number ◽  
Hospital Doctors ◽  
Diagnostic Sensitivity And Specificity ◽  
Sensitivity Specificity

IntroductionParamedics are involved in examining, treating and diagnosing patients. The accuracy of these diagnoses is evaluated using diagnostic accuracy studies. We undertook a systematic review of published literature to provide an overview of how accurately paramedics diagnose patients compared with hospital doctors. A bivariate meta-analysis was incorporated to examine the range of diagnostic sensitivity and specificity.MethodsWe searched MEDLINE, CINAHL, Embase, AMED and the Cochrane Database from 1946 to 7 May 2016 for studies where patients had been given a diagnosis by paramedics and hospital doctors. Keywords focused on study type (‘diagnostic accuracy’), outcomes (sensitivity, specificity, likelihood ratio?, predictive value?) and setting (paramedic*, pre-hospital, ambulance, ‘emergency service?’, ‘emergency medical service?’, ‘emergency technician?’).Results2941 references were screened by title and/or abstract. Eleven studies encompassing 384 985 patients were included after full-text review. The types of diagnoses in one of the studies encompassed all possible diagnoses and in the other studies focused on sepsis, stroke and myocardial infarction. Sensitivity estimates ranged from 32% to 100% and specificity estimates from 14% to 100%. Eight of the studies were deemed to have a low risk of bias and were incorporated into a meta-analysis which showed a pooled sensitivity of 0.74 (0.62 to 0.82) and a pooled specificity of 0.94 (0.87 to 0.97).DiscussionCurrent published research suggests that diagnoses made by paramedics have high sensitivity and even higher specificity. However, the paucity and varying quality of studies indicates that further prehospital diagnostic accuracy studies are warranted especially in the field of non-life-threatening conditions.PROSPERO registration numberCRD42016039306.

PP9 A systematic review and meta-analysis of pre-hospital diagnostic accuracy studies

2019 ◽  
Vol 36 (1) ◽  
pp. e4.2-e4
Author(s):  
Caitlin Wilson ◽  
Clare Harley ◽  
Stephanie Steels
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Eligibility Criteria ◽  
Cochrane Database ◽  
Full Text Review ◽  
Hospital Doctors ◽  
Diagnostic Sensitivity And Specificity ◽  
Sensitivity Specificity

BackgroundPre-hospital clinicians are involved in examining, treating and diagnosing patients. The accuracy of pre-hospital diagnoses is evaluated using diagnostic accuracy studies. We undertook a systematic review of published literature to provide an overview of how accurately pre-hospital clinicians diagnose patients compared to hospital doctors. A bivariate meta-analysis was incorporated to examine the range of diagnostic sensitivity and specificity.MethodsWe searched MEDLINE, CINAHL, Embase, AMED and the Cochrane Database of Systematic Reviews from 1946 to 7th May 2016 for studies where patients had been given a diagnosis by pre-hospital clinicians and hospital doctors. Key words focused on study type (‘diagnostic accuracy’), outcomes (sensitivity, specificity, likelihood ratio?, predictive value?) and setting (paramedic*, pre-hospital, ambulance, ‘emergency service?’, ‘emergency medical service?’, ‘emergency technician?’). The sole researcher screened titles and abstracts to ensure eligibility criteria were met, as well as assessing methodological quality using QUADAS-2.Results2941 references were screened by title and/or abstract. Eleven studies encompassing 3 84 985 patients were included after full-text review. The types of diagnoses in one of the studies encompassed all possible diagnoses and in the other studies focused on sepsis, stroke and myocardial infarction. Sensitivity estimates ranged from 32%–100% and specificity estimates from 14%–100%. Eight of the studies were deemed to have a low risk of bias and were incorporated into a meta-analysis, which showed a pooled sensitivity of 0.74 (0.62, 0.82) and a pooled specificity of 0.94 (0.87, 0.97).ConclusionsCurrent published research suggests that diagnoses made by pre-hospital clinicians have high sensitivity and even higher specificity. However, the paucity and varying quality of eligible studies indicates that further pre-hospital diagnostic accuracy studies are warranted especially in the field of non-life-threatening conditions and trauma.

scholarly journals A Systematic Review and Meta-analysis of the Diagnostic Accuracy of Nucleic Acid Amplification Tests for Tuberculous Meningitis

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Ali Pormohammad ◽  
Mohammad Javad Nasiri ◽  
Timothy D. McHugh ◽  
Seyed Mohammad Riahi ◽  
Nathan C. Bahr
Keyword(s):  
Systematic Review ◽  
Nucleic Acid ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Tuberculous Meningitis ◽  
Meta Analysis ◽  
Nucleic Acid Amplification ◽  
Data Sets ◽  
Reference Standard ◽  
Sensitivity Specificity

ABSTRACTThe diagnosis of tuberculous meningitis (TBM) is difficult and poses a significant challenge to physicians worldwide. Recently, nucleic acid amplification (NAA) tests have shown promise for the diagnosis of TBM, although their performance has been variable. We undertook a systematic review and meta-analysis to evaluate the diagnostic accuracy of NAA tests with cerebrospinal fluid (CSF) samples against that of culture as the reference standard or a combined reference standard (CRS) for TBM. We searched the Embase, PubMed, Web of Science, and Cochrane Library databases for the relevant records. The QUADAS-2 tool was used to assess the quality of the studies. Diagnostic accuracy measures (i.e., sensitivity and specificity) were pooled with a random-effects model. All statistical analyses were performed with STATA (version 14 IC; Stata Corporation, College Station, TX, USA), Meta-DiSc (version 1.4 for Windows; Cochrane Colloquium, Barcelona, Spain), and RevMan (version 5.3; The Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, Denmark) software. Sixty-three studies comprising 1,381 cases of confirmed TBM and 5,712 non-TBM controls were included in the final analysis. These 63 studies were divided into two groups comprising 71 data sets (43 in-house tests and 28 commercial tests) that used culture as the reference standard and 24 data sets (21 in-house tests and 3 commercial tests) that used a CRS. Studies which used a culture reference standard had better pooled summary estimates than studies which used CRS. The overall pooled estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of the NAA tests against culture were 82% (95% confidence interval [CI], 75 to 87%), 99% (95% CI, 98 to 99%), 58.6 (95% CI, 35.3 to 97.3), and 0.19 (95% CI, 0.14 to 0.25), respectively. The pooled sensitivity, specificity, PLR, and NLR of NAA tests against CRS were 68% (95% CI, 41 to 87%), 98% (95% CI, 95 to 99%), 36.5 (95% CI, 15.6 to 85.3), and 0.32 (95% CI, 0.15 to 0.70), respectively. The analysis has demonstrated that the diagnostic accuracy of NAA tests is currently insufficient for them to replace culture as a lone diagnostic test. NAA tests may be used in combination with culture due to the advantage of time to result and in scenarios where culture tests are not feasible. Further work to improve NAA tests would benefit from the availability of standardized reference standards and improvements to the methodology.

Diagnostic Accuracy of Dual-Energy CT in Detection of Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 084653712090206 ◽  
Author(s):  
Waleed Abdellatif ◽  
Mahmoud Ahmed Ebada ◽  
Souad Alkanj ◽  
Ahmed Negida ◽  
Nicolas Murray ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Pulmonary Embolism ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Acute Pulmonary Embolism ◽  
Meta Analysis ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Sensitivity Specificity

Purpose: In this systematic review and meta-analysis, we aimed to investigate the accuracy of dual-energy computed tomography (DECT) in the detection of acute pulmonary embolism (PE). Methods: We searched Medline (via PubMed), EBSCO, Web of Science, Scopus, and the Cochrane Library for relevant published studies. We selected studies assessing the accuracy of DECT in the detection of PE. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 tool. Meta-analysis was performed to calculate mean estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). The summary receiver operating characteristic (sROC) curve was drawn to get the Cochran Q-index and the area under the curve (AUC). Results: Seven studies were included in our systematic review. Of the 182 patients included, 108 patients had PEs. The pooled analysis showed an overall sensitivity and specificity of 88.9% (95% confidence interval [CI]: 81.4%-94.1%) and 94.6% (95% CI: 86.7%-98.5%), respectively. The pooled PLR was 8.186 (95% CI: 3.726-17.986), while the pooled NLR was 0.159 (95% CI: 0.093-0.270). Cochran-Q was 0.8712, and AUC was 0.935 in the sROC curve. Conclusion: Dual-energy computed tomography shows high sensitivity, specificity, and diagnostic accuracy in the detection of acute PE. The high PLR highlights the high clinical importance of DECT as a prevalence-independent, rule-in test. Studies with a larger sample size with standardized reference tests are still needed to increase the statistical power of the study and support these findings.

scholarly journals Diagnostic Accuracy of Confocal Laser Endomicroscopy for the Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12390
Author(s):  
Sneha Sethi ◽  
Xiangqun Ju ◽  
Richard M. Logan ◽  
Paul Sambrook ◽  
Robert A. McLaughlin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Risk Of Bias ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Likelihood Ratios

Background: Advances in treatment approaches for patients with oral squamous cell carcinoma (OSCC) have been unsuccessful in preventing frequent recurrences and distant metastases, leading to a poor prognosis. Early detection and prevention enable an improved 5-year survival and better prognosis. Confocal Laser Endomicroscopy (CLE) is a non-invasive imaging instrument that could enable an earlier diagnosis and possibly help in reducing unnecessary invasive surgical procedures. Objective: To present an up to date systematic review and meta-analysis assessing the diagnostic accuracy of CLE in diagnosing OSCC. Materials and Methods. PubMed, Scopus, and Web of Science databases were explored up to 30 June 2021, to collect articles concerning the diagnosis of OSCC through CLE. Screening: data extraction and appraisal was done by two reviewers. The quality of the methodology followed by the studies included in this review was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random effects model was used for the meta-analysis. Results: Six studies were included, leading to a total number of 361 lesions in 213 patients. The pooled sensitivity and specificity were 95% (95% CI, 92–97%; I2 = 77.5%) and 93% (95% CI, 90–95%; I2 = 68.6%); the pooled positive likelihood ratios and negative likelihood ratios were 10.85 (95% CI, 5.4–21.7; I2 = 55.9%) and 0.08 (95% CI, 0.03–0.2; I2 = 83.5%); and the pooled diagnostic odds ratio was 174.45 (95% CI, 34.51–881.69; I2 = 73.6%). Although risk of bias and heterogeneity is observed, this study validates that CLE may have a noteworthy clinical influence on the diagnosis of OSCC, through its high sensitivity and specificity. Conclusions: This review indicates an exceptionally high sensitivity and specificity of CLE for diagnosing OSCC. Whilst it is a promising diagnostic instrument, the limited number of existing studies and potential risk of bias of included studies does not allow us to draw firm conclusions. A conclusive inference can be drawn when more studies, possibly with homogeneous methodological approach, are performed.

scholarly journals A systematic review and meta-analysis to evaluate the diagnostic accuracy of recognition of stroke in the emergency department (ROSIER) scale

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fei Han ◽  
Chao Zuo ◽  
Guodong Zheng
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Medical Personnel ◽  
Female Ratio ◽  
Clinical Applicability ◽  
Sensitivity Specificity ◽  
Test Probability

Abstract Background The present study aims to evaluate the performance and the clinical applicability of the Recognition of Stroke in the Emergency Department (ROSIER) scale via systematic review and meta-analysis. Methods Electronic databases of Pubmed and Embase were searched between 1st January 2005 (when ROSIER developed) and 8th May 2020. Studies that evaluated the diagnostic accuracy of the ROSIER scale were included. The sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were combined using a bivariate mixed-effects model. Fagan nomogram was used to evaluate the clinical applicability of the ROSIER scale. Results A total of 14 studies incorporating 15 datasets were included in this meta-analysis. The combined sensitivity, specificity, DOR and AUC were 0.88 [95% confidence interval (CI): 0.83–0.91], 0.66 (95% CI: 0.52–0.77), 13.86 (95% CI, 7.67–25.07) and 0.88 (95% CI, 0.85–0.90), respectively. Given the pre-test probability of 60.0%, Fagan nomogram suggested the post-test probability was increased to 79% when the ROSIER was positive. In comparison, it was decreased to 22% when ROSIER was negative. Subgroup analysis showed that the pooled sensitivity of ROSIER in the European population was higher than that in Asia. In contrast, the pooled specificity was not significantly different between them. Moreover, results also suggested the male-to-female ratio ≤ 1.0 subgroup, prehospital setting subgroup, and other trained medical personnel subgroup had significantly higher sensitivity compared with their counterparts. At the same time, no significant differences were found in the pooled specificity between them. Conclusions ROSIER is a valid scale with high clinical applicability, which has not only good diagnostic accuracy in Europe but also shows excellent performance in Asia. Moreover, the ROSIER scale exhibits good applicability in prehospital settings with other trained medical personnel.

scholarly journals Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018280 ◽  
Author(s):  
Rahel Buechi ◽  
Livia Faes ◽  
Lucas M Bachmann ◽  
Michael A Thiel ◽  
Nicolas S Bodmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Quality Assessment ◽  
Meta Analysis ◽  
Reporting Quality ◽  
Diagnostic Value ◽  
Summary Estimate ◽  
Registration Number ◽  
Business Source Premier ◽  
Smartphone Sensors

ObjectiveThe number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors.MethodsSystematic Review—MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the ’STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised.ResultsWe screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity.ConclusionsThe diagnostic evidence of available health apps on Apple’s and Google’s app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them.PROSPERO registration number42016033049.

scholarly journals Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027851
Author(s):  
Maximilian Salcher-Konrad ◽  
Huseyin Naci ◽  
David McDaid ◽  
Suvarna Alladi ◽  
Deborah Oliveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Secondary Analysis ◽  
Routine Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cochrane Database ◽  
Registration Number ◽  
Meta Analyses ◽  
Low And Middle Income

IntroductionThere are more people living with dementia in low- and middle-income countries (LMICs) than in high-income countries. Evidence-based interventions to improve the lives of people living with dementia and their carers are needed, but a systematic mapping of methodologically robust studies in LMICs and synthesis of the effectiveness of dementia interventions in these settings is missing.Methods and analysisA systematic review and meta-analysis will be conducted to answer the question: Which dementia interventions were shown to be effective in LMICs and how do they compare to each other? Electronic database searches (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit, Cochrane Database of Systematic Reviews) will be complemented by hand searching of reference lists and local knowledge of existing studies from an international network of researchers in dementia from LMICs. Studies will be eligible for inclusion if they were published between 2008 and 2018, conducted in LMICs and evaluated the effectiveness of a dementia intervention using a study design that supports causal inference of the treatment effect. We will include both randomised and non-randomised studies due to an anticipated low number of well-conducted randomised trials in LMICs and potentially greater external validity of non-randomised studies conducted in routine care settings. In addition to narrative synthesis of the interventions, feasibility of pairwise and network meta-analyses will be explored to obtain pooled effects of relative treatment effects.Ethics and disseminationSecondary analysis of published studies, therefore no ethics approval required. Planned dissemination channels include a peer-reviewed publication as well as a website, DVD and evidence summaries.Prospero registration numberCRD42018106206.

scholarly journals Diagnostic Accuracy of Ambulatory Devices in Detecting Atrial Fibrillation: Systematic Review and Meta-analysis

10.2196/26167 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e26167
Author(s):  
Tien Yun Yang ◽  
Li Huang ◽  
Shwetambara Malwade ◽  
Chien-Yi Hsu ◽  
Yang Ching Chen
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Systematic Reviews ◽  
Subgroup Analysis ◽  
Gold Standard ◽  
Meta Analysis ◽  
Automatic Interpretation ◽  
Sensitivity Specificity

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Early diagnosis of AF is crucial for preventing AF-related morbidity, mortality, and economic burden, yet the detection of the disease remains challenging. The 12-lead electrocardiogram (ECG) is the gold standard for the diagnosis of AF. Because of technological advances, ambulatory devices may serve as convenient screening tools for AF. Objective The objective of this review was to investigate the diagnostic accuracy of 2 relatively new technologies used in ambulatory devices, non-12-lead ECG and photoplethysmography (PPG), in detecting AF. We performed a meta-analysis to evaluate the diagnostic accuracy of non-12-lead ECG and PPG compared to the reference standard, 12-lead ECG. We also conducted a subgroup analysis to assess the impact of study design and participant recruitment on diagnostic accuracy. Methods This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE and EMBASE were systematically searched for articles published from January 1, 2015 to January 23, 2021. A bivariate model was used to pool estimates of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating curve (SROC) as the main diagnostic measures. Study quality was evaluated using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Results Our search resulted in 16 studies using either non-12-lead ECG or PPG for detecting AF, comprising 3217 participants and 7623 assessments. The pooled estimates of sensitivity, specificity, PLR, NLR, and diagnostic odds ratio for the detection of AF were 89.7% (95% CI 83.2%-93.9%), 95.7% (95% CI 92.0%-97.7%), 20.64 (95% CI 10.10-42.15), 0.11 (95% CI 0.06-0.19), and 224.75 (95% CI 70.10-720.56), respectively, for the automatic interpretation of non-12-lead ECG measurements and 94.7% (95% CI 93.3%-95.8%), 97.6% (95% CI 94.5%-99.0%), 35.51 (95% CI 18.19-69.31), 0.05 (95% CI 0.04-0.07), and 730.79 (95% CI 309.33-1726.49), respectively, for the automatic interpretation of PPG measurements. Conclusions Both non-12-lead ECG and PPG offered high diagnostic accuracies for AF. Detection employing automatic analysis techniques may serve as a useful preliminary screening tool before administering a gold standard test, which generally requires competent physician analyses. Subgroup analysis indicated variations of sensitivity and specificity between studies that recruited low-risk and high-risk populations, warranting future validity tests in the general population. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020179937; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=179937

scholarly journals The diagnostic accuracy of smartwatches for the detection of cardiac arrhythmia: A systematic review and meta-analysis. (Preprint)

2021 ◽  
Author(s):  
Scarlet Nazarian ◽  
Kyle Lam ◽  
Ara Darzi ◽  
Hutan Ashrafian
Keyword(s):  
Diagnostic Accuracy ◽  
Cardiac Arrhythmia ◽  
Cardiac Arrhythmias ◽  
Financial Burden ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Regulatory Standards ◽  
Registration Number ◽  
Sensitivity Specificity

BACKGROUND A significant morbidity, mortality and financial burden is associated with cardiac rhythm abnormalities. Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. Conventional screening tools are often unsuccessful at detecting AF due to its episodic nature. Smartwatches have gained popularity in recent years as a health screening tool. OBJECTIVE The aim of our study was to systematically review and meta-analyse the diagnostic accuracy of smartwatches in the detection of cardiac arrhythmias. METHODS A comprehensive literature search was undertaken using the databases of EMBASE, Medline and the Cochrane Library. PRISMA guidance was followed. Studies reporting use of a smartwatch for detection of cardiac arrythmia were included. Independent proportion and their differences were calculated and pooled through DerSimonian and Laird random-effects modelling. Quality was assessed using the QUADAS-2 tool. RESULTS A total of 18 studies were analysed, measuring diagnostic accuracy in 424, 371 subjects in total. The overall sensitivity, specificity and accuracy of smartwatches to detect cardiac arrhythmias was 100% (95% CI 0.99-1.00), 95% (95% CI 0.93-0.97) and 97% (95% CI 0.96-0.99), respectively. The pooled PPV and NPV for detecting cardiac arrythmias was 85% 85% (95% CI 0.79-0.90) and 100% (95% CI 1.0-1.0), respectively. CONCLUSIONS This review demonstrates the evolving field of digital disease screening and the increased role of machine learning in healthcare. The current diagnostic accuracy of smartwatch technology for detection of cardiac arrhythmias is high. Whilst the innovative drive of digital devices in healthcare screening will continue to gain momentum, the process of accurate evidence accrual and regulatory standards ready to accept their introduction is strongly needed. CLINICALTRIAL PROSPERO registration number: CRD42020213237

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