scholarly journals Atrial fibrillation in a primary care population: how close to NICE guidelines are we?

2009 ◽  
Vol 9 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Bryan Loo ◽  
Cath Parnell ◽  
Gerald Brook ◽  
Ed Southall ◽  
Ian Mahy
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Nice Guidelines ◽  
Primary Care Population

Abstract 16403: Prevalence and Sex Differences in Early-onset Atrial Fibrillation - A Nation-wide Primary Care Study in Norway

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Silje M Kalstø ◽  
Ståle Nygård ◽  
Arnljot Tveit ◽  
Inger Ariansen ◽  
Ingrid E Christophersen
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Sex Differences ◽  
Early Onset ◽  
Age Groups ◽  
Age Group ◽  
Lone Atrial Fibrillation ◽  
Primary Care Population ◽  
Primary Care Sector

Background: Several studies have reported a male:female ratio of 4:1 in lone atrial fibrillation (AF) populations. However, there have been few reports on the young population with AF, and no reports from a primary care setting. Here, we describe prevalence and sex-differences in early-onset AF in a nation-wide register-based study in the primary care sector in Norway. Methods: In Norway, with a population of 5.4 million, healthcare is publicly financed and all general practitioner (GP) claims have been recorded in the Norwegian Control and Payment of Health Reimbursement (KUHR) registry, since 2006. We identified all individuals aged ≥18 and <50 years registered with ≥1 AF diagnosis code (International Classification of Primary Care (ICPC) K78), from 2006-2019 in the KUHR registry. Based on population estimates from Statistics Norway, we calculated the prevalence of early-onset AF in 2019, as a total, by sex, and by age groups: 18-29, 30-39, 40-49. Results: We identified 5563 individuals (28.5% women, age 18-49 years) aged 18-49 in 2019 with AF diagnosed <age 50 years. In 2019, the prevalence of early-onset AF registered in all individuals up to age 50 was 0.24% (women: 0.14% (1585/1114821), men 0.34% (3978/1176555), p=1.4x10 -205 ) with a ratio of 2.5 men:women. In individuals aged 18-29 the prevalence was 0.05% (women 0.04% (164/410367), men 0.07% (292/435001), p=79x10 -8 ). For the age group 30-39 years the prevalence was 0.19% (women 0.12% (408/349639), men 0.27% (985/367730), p=3.9x10 -49 ). For the age group 40-49 years the prevalence was 0.51% (women 0.29% (1013/354815), men 0.72% (2701/373824), p=1.39x10 -155 ). Conclusion: We show that the prevalence of early-onset AF in a nation-wide primary care population is 0.24% and that the sex-difference in prevalence is smaller than previously reported in early-onset and lone AF studies. Our findings underline the need of increased awareness of AF as a disease in the young, and particularly to women in the youngest age-groups.

scholarly journals Does the evidence referenced in NICE guidelines reflect a primary care population?

2011 ◽  
Vol 61 (584) ◽  
pp. e112-e117 ◽  
Author(s):  
Paul Scullard ◽  
Asmaa Abdelhamid ◽  
Nick Steel ◽  
Nadeem Qureshi
Keyword(s):  
Primary Care ◽  
Nice Guidelines ◽  
Primary Care Population

Behavioral and biologic evidence of persistent high-risk behavior in an HIV primary care population

AIDS ◽  
2000 ◽  
Vol 14 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Emily J. Erbelding ◽  
David Stanton ◽  
Thomas C. Quinn ◽  
Anne Rompalo
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Risk Behavior ◽  
High Risk Behavior ◽  
Primary Care Population ◽  
Hiv Primary Care

scholarly journals CHARGE-AF in a national routine primary care electronic health records database in the Netherlands: validation for 5-year risk of atrial fibrillation and implications for patient selection in atrial fibrillation screening

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001459
Author(s):  
Jelle C L Himmelreich ◽  
Wim A M Lucassen ◽  
Ralf E Harskamp ◽  
Claire Aussems ◽  
Henk C P M van Weert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
High Risk ◽  
The Netherlands ◽  
Patient Selection ◽  
Low Cost ◽  
Calibration Plot ◽  
Primary Care Data ◽  
C Statistic ◽  
Kaplan Meier

AimsTo validate a multivariable risk prediction model (Cohorts for Heart and Aging Research in Genomic Epidemiology model for atrial fibrillation (CHARGE-AF)) for 5-year risk of atrial fibrillation (AF) in routinely collected primary care data and to assess CHARGE-AF’s potential for automated, low-cost selection of patients at high risk for AF based on routine primary care data.MethodsWe included patients aged ≥40 years, free of AF and with complete CHARGE-AF variables at baseline, 1 January 2014, in a representative, nationwide routine primary care database in the Netherlands (Nivel-PCD). We validated CHARGE-AF for 5-year observed AF incidence using the C-statistic for discrimination, and calibration plot and stratified Kaplan-Meier plot for calibration. We compared CHARGE-AF with other predictors and assessed implications of using different CHARGE-AF cut-offs to select high-risk patients.ResultsAmong 111 475 patients free of AF and with complete CHARGE-AF variables at baseline (17.2% of all patients aged ≥40 years and free of AF), mean age was 65.5 years, and 53% were female. Complete CHARGE-AF cases were older and had higher AF incidence and cardiovascular comorbidity rate than incomplete cases. There were 5264 (4.7%) new AF cases during 5-year follow-up among complete cases. CHARGE-AF’s C-statistic for new AF was 0.74 (95% CI 0.73 to 0.74). The calibration plot showed slight risk underestimation in low-risk deciles and overestimation of absolute AF risk in those with highest predicted risk. The Kaplan-Meier plot with categories <2.5%, 2.5%–5% and >5% predicted 5-year risk was highly accurate. CHARGE-AF outperformed CHA2DS2-VASc (Cardiac failure or dysfunction, Hypertension, Age >=75 [Doubled], Diabetes, Stroke [Doubled]-Vascular disease, Age 65-74, and Sex category [Female]) and age alone as predictors for AF. Dichotomisation at cut-offs of 2.5%, 5% and 10% baseline CHARGE-AF risk all showed merits for patient selection in AF screening efforts.ConclusionIn patients with complete baseline CHARGE-AF data through routine Dutch primary care, CHARGE-AF accurately assessed AF risk among older primary care patients, outperformed both CHA2DS2-VASc and age alone as predictors for AF and showed potential for automated, low-cost patient selection in AF screening.

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