Feasibility of Atrial Fibrillation Screening With Mobile Health Technologies at Pharmacies

2019 ◽  
Vol 25 (2) ◽  
pp. 142-151 ◽  
Author(s):  
Tomasz Zaprutko ◽  
Joanna Zaprutko ◽  
Artur Baszko ◽  
Dominika Sawicka ◽  
Anna Szałek ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sensitivity And Specificity ◽  
Mobile Health ◽  
Predictive Value ◽  
High Sensitivity ◽  
Exclusion Criterion ◽  
Health Technologies ◽  
Fast Screening ◽  
Ischemic Attack ◽  
Electrocardiogram Ecg

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Thus, the aim of our study was to evaluate the smartphone-based electrocardiogram (ECG) recordings aimed at AF screening at Polish pharmacies. Methods: Prospective AF screening among patients aged ≥65 years was conducted at 10 pharmacies using Kardia Mobile with a dedicated application (Kardia app). Prior AF was a study exclusion criterion. CHA2DS2-VASc score (congestive heart failure, hypertension, age, diabetes mellitus, previous stroke/transient ischemic attack, female sex, and vascular disease) has been collected from every patient. A single-lead ECG has been acquired by the placement of fingers from each hand on the pads. Kardia app diagnosis has been evaluated by the cardiologist. Results: A total of 525 ECGs were performed. Kardia app diagnosis was provided in 490 cases. In 437 (89.18%) cases, it was “normal” rhythm, in 17 (3.47%) recordings “possible AF,” in 23 (4.69%) ECGs “unreadable,” and in 13 (2.65%) “unclassified”. After the cardiologist reevaluation, the new AF was identified in 7 (1.33%) patients. Sensitivity and specificity of Kardia app in detecting AF was 100% (95% confidence interval [CI]: 71.5%-100%) and 98.7% (95% CI: 97.3%-99.5%), respectively. The positive predictive value was 64.7% (95% CI: 38.3%-85.7%) and the negative predictive value was 100% (95% CI: 99.2%-100%). CHA2DS2-VASc score was 2.14 ± 0.69 for those with new AF and 3.33 ± 1.26 in the non-AF group. Conclusion: Kardia app is capable of fast screening and detecting AF with high sensitivity and specificity. The possible diagnosis of AF deserves additional cardiological evaluation. The results obtained in patients with low CHA2DS2-VASc score and “silent” AF confirm the importance of routine AF screening. Cardiovascular screening with the use of mobile health technology is feasible at pharmacies.

P6578Development of the novel program to diagnose atrial fibrillation using automated blood pressure monitor

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ishizawa ◽  
T Noma ◽  
S Ishikawa ◽  
K Matsunaga ◽  
R Kawakami ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Sensitivity And Specificity ◽  
Pressure Pulse ◽  
High Sensitivity ◽  
Cardiac Patients ◽  
The Novel ◽  
Waveform Data ◽  
Medical Needs ◽  
Increased Risk

Abstract Background Atrial fibrillation (AF) is often asymptomatic and contributes to an increased risk of strokes. The development of proper screening device of AF is unmet medical needs worldwide. Recently, we had reported that multiple measurements using Omron automated blood pressure (BP) monitor with irregular heartbeat detection showed high sensitivity and specificity for AF detection in general cardiac patients, however, this method had limitations in discriminating between AF and other arrhythmias. Purpose The aim of this study is to develop a novel program that can accurately diagnose AF by discriminating it from other arrhythmias using the pressure pulse waveform data outputted from Omron automated BP monitor. Methods In our previous clinical research, BP measurements were performed 3 times each for 303 general cardiac patients (mean age: 72.2 years, 69.8% male) with recording the real-time single lead ECG, and a total of 909 pressure pulse waveforms were obtained. Among them, 840 pressure pulse waveforms from 280 patients (include 40 AF patients) used for further analysis. We developed a program to analyze and visualize uniquely the characteristics of AF waveform through the autocorrelation-based waveform processing system produced by Melody International Ltd, Kagawa, Japan. All visualized results were judged and classified into Sinus, Non-AF and AF by two individuals blinded to the results. For each patient who obtained 3 results, a two by two contingency table was created and sensitivity, specificity, and accuracy for diagnosing AF were calculated. Results Among 840 pressure pulse waveforms, only 21 (2 Sinus and 19 Non-AF) out of 720 Sinus and Non-AF waveforms were judged as AF, and 7 out of 120 AF waveforms were judged as Non-AF. None of AF waveforms was absolutely misjudged as Sinus. In analysis for each patient, when one or more AF judgements were found in 3 waveforms, the diagnosis of AF has sensitivity and specificity of 100% and 95.8%, respectively. When two or more AF judgements were found in 3 waveforms, the diagnosis of AF has sensitivity and specificity of 100% and 97.9%, respectively. In this rule, the diagnostic accuracy of AF reached up to 98.8%, and no sinus patients were misjudged as AF. Conclusion The novel program, which applied autocorrelation methods uniquely to analysis of the pressure pulse waveforms recorded by automated BP monitor, showed high sensitivity and high specificity for AF diagnosis in general cardiac patients. This program is expected to be useful for early diagnosis for asymptomatic AF patients. Acknowledgement/Funding The present research is supported by a grant through the SCOPE from the Ministry of Internal Affairs and Communications, Japan.

Standardization and characterization of antigens for the diagnosis of aspergillosis

2012 ◽  
Vol 58 (4) ◽  
pp. 455-462 ◽  
Author(s):  
Cheila Denise Ottonelli Stopiglia ◽  
Alicia Arechavala ◽  
Mariana Carissimi ◽  
Julia Medeiros Sorrentino ◽  
Valério Rodrigues Aquino ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Aspergillus Niger ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
High Sensitivity ◽  
Antigenic Activity ◽  
Sds Page ◽  
Mascot Search Engine ◽  
Commercial Kit

The aim of this study was to develop and characterize antigens for the diagnosis of aspergillosis. Nine strains of Aspergillus species Aspergillus fumigatus , Aspergillus flavus , and Aspergillus niger were grown in Sabouraud and Smith broth to produce exoantigens. The antigens were tested by immunodiffusion against sera from patients with aspergillosis and other systemic mycoses. The protein fraction of the antigens was detected by SDS–PAGE; Western blot and representative bands were assessed by mass spectrometry coupled to a nano Acquity UltraPerformance LC and analyzed by the Mascot search engine. Concurrently, all sera were tested with Platelia Aspergillus EIA. The most reactive antigens to sera from patients infected by A. fumigatus were produced by A. fumigatus MG2 Sabouraud and pooled A. fumigatus Sabouraud samples, both with a sensitivity of 93% and specificity of 100% and 97%, respectively. Aspergillus niger and A. flavus antigens were reactive against A. niger and A. flavus sera, each one with a sensitivity and specificity of 100%. Two proteins, probably responsible for antigenic activity, β-glucosidase in A. fumigatus and α-amylase in A. niger were attained. The commercial kit had a specificity of 22%, sensitivity of 100%, positive predictive value of 48%, and negative predictive value of 100%. The antigens produced showed high sensitivity and specificity and can be exploited for diagnostics of aspergilloma.

scholarly journals Lung Ultrasound in the Screening of Pulmonary Interstitial Involvement Secondary to Systemic Connective Tissue Disease: A Prospective Pilot Study Involving 180 Patients

2021 ◽  
Vol 10 (18) ◽  
pp. 4114
Author(s):  
Natalia Buda ◽  
Anna Wojteczek ◽  
Anna Masiak ◽  
Maciej Piskunowicz ◽  
Wojciech Batko ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Lung Ultrasound ◽  
Imaging Modality ◽  
Connective Tissue Diseases ◽  
High Sensitivity ◽  
Study Group ◽  
A Prospective Study

Objectives: The aim of the study was the assessment of lung ultrasound (LUS) as a screening of pulmonary interstitial involvement secondary to systemic connective tissue diseases. Methods: A prospective study was conducted on the study group comprising 180 patients diagnosed with different systemic connective tissue diseases. Each patient underwent lung ultrasound (LUS), high-resolution chest computed tomography (HRCT), and echocardiography (ECHO). Each imaging examination was blinded and performed by an independent operator. LUS was conducted with convex and linear transducers. Results: The sensitivity and specificity of LUS as compared to HRCT in detecting pulmonary interstitial involvement in the study group were 99.3% and 96.4%, respectively; positive predictive value (PPV) 0.7, negative predictive value (NPV) 3.6. Abnormalities indicating interstitial lung disease (ILD) with fibrosis were most frequently localized bilaterally in the lower fields of the lungs, assessed in the dorsal view. Conclusions: LUS is an efficient imaging modality that can detect pulmonary interstitial involvement in patients with systemic connective tissue disease with a high sensitivity and specificity. Further prospective studies conducted on a larger population are deemed necessary.

scholarly journals Evaluation of tubal patency by sonosalpingography is as good as hysterosalpingography in infertile women

2017 ◽  
Vol 6 (11) ◽  
pp. 5129
Author(s):  
C. Santhana Lakshmi ◽  
Kumara Sampath ◽  
Parvatha Vardani
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
High Sensitivity ◽  
Tubal Patency ◽  
Less Invasive ◽  
Significant Difference ◽  
Invasive Method ◽  
Tubal Factor ◽  
Primary Health Care Centers ◽  
Health Care Centers

Background: Tubal pathology is one of the causes of infertility in sub fertile couples. Therefore, evaluation of fallopian tubes forms an essential part of evaluation in a sub fertile woman. The aim of the study was to compare the efficacy of sonosalpingography which is a less invasive method when compared to hysterosalpingogram for evaluation of utero-tubal factor in females.Methods: A total of 95 patients 69 with primary infertility and 26 with secondary infertility attending our Obstetrics and Gynecology department were recruited for the study from June 2016 to July 2017. All the study subjects underwent Sonosalpingography on day 5th to 7th and Hysterosalpingography on 7th to 9th day of the menstrual cycle. Data was collected and compared to assess the sensitivity and specificity of sonosalpingography over hysterosalpingography. Statistical analysis was done by using SPSS software version 16.0.Results: Sonosalpingography (SSG) has 97% sensitivity and 94% specificity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 98.3% and negative predictive value of 75%. From the results of this study it clear that there is no statistically significant difference (p = 0.237) between the results of the two methods (SSG and HSG).Conclusions: As sonosalpingogrpahy has high sensitivity and specificity and is less invasive. It should be used initially to assess tubal patency in cases of infertility. SSG is found to be a reliable, relatively less expensive diagnostic and therapeutic procedure in the management of infertility in females. Easy availability and accessibility of ultrasound in all primary health care centers definitely can prove superior to conventional method of diagnosis of tubal patency in such patient.

scholarly journals Automatic Mobile Health Arrhythmia Monitoring for the Detection of Atrial Fibrillation: Prospective Feasibility, Accuracy, and User Experience Study

10.2196/29933 ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. e29933
Author(s):  
Onni E Santala ◽  
Jari Halonen ◽  
Susanna Martikainen ◽  
Helena Jäntti ◽  
Tuomas T Rissanen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mobile Phone ◽  
Monitoring System ◽  
Sensitivity And Specificity ◽  
User Experience ◽  
Mobile Health ◽  
Visual Interpretation ◽  
Arrhythmia Detection ◽  
Mobile Phone Application ◽  
Rhythm Monitoring

Background Atrial fibrillation (AF) is the most common tachyarrhythmia and associated with a risk of stroke. The detection and diagnosis of AF represent a major clinical challenge due to AF’s asymptomatic and intermittent nature. Novel consumer-grade mobile health (mHealth) products with automatic arrhythmia detection could be an option for long-term electrocardiogram (ECG)-based rhythm monitoring and AF detection. Objective We evaluated the feasibility and accuracy of a wearable automated mHealth arrhythmia monitoring system, including a consumer-grade, single-lead heart rate belt ECG device (heart belt), a mobile phone application, and a cloud service with an artificial intelligence (AI) arrhythmia detection algorithm for AF detection. The specific aim of this proof-of-concept study was to test the feasibility of the entire sequence of operations from ECG recording to AI arrhythmia analysis and ultimately to final AF detection. Methods Patients (n=159) with an AF (n=73) or sinus rhythm (n=86) were recruited from the emergency department. A single-lead heart belt ECG was recorded for 24 hours. Simultaneously registered 3-lead ECGs (Holter) served as the gold standard for the final rhythm diagnostics and as a reference device in a user experience survey with patients over 65 years of age (high-risk group). Results The heart belt provided a high-quality ECG recording for visual interpretation resulting in 100% accuracy, sensitivity, and specificity of AF detection. The accuracy of AF detection with the automatic AI arrhythmia detection from the heart belt ECG recording was also high (97.5%), and the sensitivity and specificity were 100% and 95.4%, respectively. The correlation between the automatic estimated AF burden and the true AF burden from Holter recording was >0.99 with a mean burden error of 0.05 (SD 0.26) hours. The heart belt demonstrated good user experience and did not significantly interfere with the patient’s daily activities. The patients preferred the heart belt over Holter ECG for rhythm monitoring (85/110, 77% heart belt vs 77/109, 71% Holter, P=.049). Conclusions A consumer-grade, single-lead ECG heart belt provided good-quality ECG for rhythm diagnosis. The mHealth arrhythmia monitoring system, consisting of heart-belt ECG, a mobile phone application, and an automated AF detection achieved AF detection with high accuracy, sensitivity, and specificity. In addition, the mHealth arrhythmia monitoring system showed good user experience. Trial Registration ClinicalTrials.gov NCT03507335; https://clinicaltrials.gov/ct2/show/NCT03507335

scholarly journals Evaluation of a Rapid Kit for Detection of IgM against Leptospira in Human

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Mohan Rao ◽  
Fairuz Amran ◽  
Nadia Aqilla
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Clinical Manifestations ◽  
Rapid Test ◽  
Febrile Illness ◽  
High Sensitivity ◽  
Confirmatory Test ◽  
Standard Laboratory ◽  
Test Efficiency ◽  
Sensitivity Specificity

Introduction. Leptospirosis is an acute febrile illness, known for its protean clinical manifestations and the challenge in differentiating from other infectious diseases. Standardized confirmatory test is antibody dependent and not accessible by the suburban community. This study measures efficiency of an immune-chromatographic assay, Leptocheck WB, in detecting acute leptospirosis. Methods. A total of 142 sera were used for kit evaluation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated by comparing rapid kit results with gold standard laboratory, microscopic agglutination test (MAT). Results. We found this rapid kit to have a sensitivity and specificity of 66.6% and 78.9%, respectively, whereas the PPV and NPV of the kit appeared to be 73.3% and 73.2%, respectively. Discussion. Test efficiency of this rapid kit is reasonable. It is specific in detecting leptospiral antibody and assures clinician of accurate diagnosis by having higher PPV and NPV. It is prompt and efficient in comparison with conventional methods in assisting differential diagnosis. High sensitivity and specificity leptospirosis rapid test is indeed a crucial measure to assist the diagnosis of acute undifferentiated febrile illnesses.

scholarly journals Detecting proteinuria: A comparison of diagnostic tests

2011 ◽  
Vol 51 (1) ◽  
pp. 17
Author(s):  
Jeanida Mauliddina ◽  
Rosmayanti Siregar ◽  
Oke Rina Ramayani ◽  
Rafita Ramayati ◽  
Rusdidjas Rusdidjas
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Sulfosalicylic Acid ◽  
Cross Sectional ◽  
Renal Disorders ◽  
Acid Test ◽  
Urine Specimens

Background Proteinuria is a condition when protein is found in urine, a common symptom in children with renal disorders. Proteinuria can also be found in nonnal children and in those with non-renal disorders. A high sensitivity test is needed to detect proteinuria. Spectrophotometry has been used as a standard to detect proteinuria, however, it is expensive and not readily available in health clinics. We tested the use of20% sulfosalicylic add to detect proteinuria, and compared it to spectrophotometry. The sulfosalicylic add test is inexpensive, rapid, and easily performed in primary community health centers.Objective To compare 2 0 % sulfosalicylic acid test t o spectrophotometry as a diagnostic test for proteinuria.Methods We conducted a cross-sectional study in Adam Malik Hospital from September 2009 until December 2009. Inclusion criteria were children aged 3 to 18 years who experienced kidney disease. We collected 24 hour urine specimens from 55 children by consecutive sampling. Urine specimens were tested for proteinuria by 20% sulfosalicylic acid test and spectrophotometry.Results Sensitivity and specificity of 20% sulfosalicylic acid test compared to spectrophotometry were 88.1 % and 69.2%, respectively, with a positive predictive value and a negative predictive value of 90.2% and 64.3%, respectively.Conclusion The sulfosalicylic acid test had low sensitivity and specificity for detecting proteinuria, but it was more practical and less expensive compared to spectrophotometry.

Diagnostic Performance Of Radiology Residents In Thoracic Ct Imaging In Emergency Radiology During The Covid-19 Pandemic

2021 ◽  
Vol 17 ◽  
Author(s):  
Vefa Cakmak ◽  
Duygu Herek ◽  
Pinar Cakmak
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
High Sensitivity ◽  
Ct Images ◽  
Roc Curve Analysis ◽  
Thoracic Ct ◽  
Thoracic Computed Tomography ◽  
Radiology Residents ◽  
And Gender

Background: During the COVID-19 pandemic, the workload of all radiologists and radiology residents, as well as other clinical physicians, has increased. Introduction: This study aims to determine the diagnostic performance of radiology residents, who effectively contribute to the diagnosis of COVID-19. Methods: The thoracic computed tomography (CT) images of 135 patients aged 20–83 diagnosed with COVID-19 were evaluated retrospectively by five radiology residents and a radiologist with 10 years of experience. The diagnostic performance of the radiology residents in evaluating COVID-19 was assessed according to their year of residency and the patients’ age and gender. Receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of radiology residents. Results: The radiology residents’ performance in determining COVID-19 using CT findings was evaluated as follows: sensitivity 97.22%, specificity 88.89%, positive predictive value 90.91%, negative predictive value 96.55%, and accuracy 93.33%. According to the year of residency, the sensitivity and specificity of the radiology residents in determining COVID-19 using CT images were between 92.3% and 100%, and 71.43% and 100%, respectively. Conclusion: The high sensitivity and specificity of radiology residents in evaluating thoracic CT images for COVID-19 diagnosis indicate that radiologists are as important as clinical physicians in the diagnosis of COVID-19.

scholarly journals The use of neurovascular ultrasound versus digital subtraction angiography in acute ischemic stroke

2015 ◽  
Vol 73 (3) ◽  
pp. 218-222 ◽  
Author(s):  
Marcos C. Lange ◽  
Tatiana P. Bruch ◽  
Jeff C. Pedrozo ◽  
Luana Maranha ◽  
Thiago Mamôru Sakae ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Admission ◽  
Acute Ischemic Stroke ◽  
Digital Subtraction Angiography ◽  
Sensitivity And Specificity ◽  
Transient Ischemic Attack ◽  
Ultrasound Examination ◽  
High Sensitivity ◽  
Digital Subtraction ◽  
Ischemic Attack

Cervical and intracranial arterial evaluation is an important issue for acute ischemic stroke (IS). Objective Compare the use of the neurovascular ultrasound examination (NVUE) to digital subtraction angiography (DSA) in acute IS patients for diagnosing significant extracranial and intracranial arteriopathy. Method Nonconsecutive patients with IS or transient ischemic attack admitted within 12 hours of the onset of symptoms were evaluated retrospectively. Standardized NVUE and DSA were done in all patients within the first 120 hours of hospital admission. Results Twenty-four patients were included in the study. Compared to DSA, the NVUE demonstrated 94.7% sensitivity and 100% specificity for identifying symptomatic extracranial and/or intracranial arteriopathy. Conclusion The standardized NVUE technique demonstrated high sensitivity and specificity compared to DSA for diagnosing arterial abnormalities in acute IS patients.

scholarly journals Low Incidence of Atrial Fibrillation in Patients with Transient Ischemic Attack

2016 ◽  
Vol 6 (3) ◽  
pp. 140-149 ◽  
Author(s):  
Kenneth Bruun Pedersen ◽  
Alexander Chemnitz ◽  
Charlotte Madsen ◽  
Niels C.F. Sandgaard ◽  
Søren Bak ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Diagnostic Yield ◽  
Holter Monitoring ◽  
University Hospital ◽  
Low Incidence ◽  
Ischemic Attack ◽  
Electrocardiogram Ecg ◽  
Current Guidelines

Background: Atrial fibrillation (AF) is a major cause of stroke. Therefore, all patients with ischemic stroke or transient ischemic attack (TIA) should be examined with 12-lead electrocardiogram (ECG) and continuous monitoring to detect AF. Current guidelines recommend at least 24 h continuous ECG monitoring, which is primarily based on studies investigating patients with ischemic stroke. The aim of our study was to investigate the diagnostic yield of 12-lead ECG and Holter monitoring in patients with TIA. Methods: We retrospectively investigated all patients diagnosed with TIA at Odense University Hospital, Denmark, from January 1, 2014 to December 31, 2014. TIA was a clinical diagnosis according to the WHO definition. Patients received admission ECG and 72-hour Holter monitoring after discharge. Results: 171 patients without known AF were diagnosed with TIA. Four (2.3%) were diagnosed with AF on admission ECG. Another 2 (1.2%) were diagnosed with AF on Holter monitoring. In total, 6 patients (3.5%) were diagnosed with AF. Patients with AF were significantly older (mean age 79.4 [95% CI 65.1-93.6] years) than patients without AF (mean age 67.6 [95% CI 65.6-69.5] years) but otherwise showed no difference in baseline characteristics. Conclusion: In this retrospective study, patients with TIA had a low incidence of AF detected with ECG and 72-hour Holter monitoring. Prospective studies are needed to confirm these findings.

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