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Related Concept Videos

Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches01:23

Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches

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Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
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Risk-based screening for the evaluation of atrial fibrillation in general practice (R-BEAT): a randomized cross-over

Robert Murphy1, Ruairi Waters1, Andrew Murphy2,3

  • 1HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland.

QJM : Monthly Journal of the Association of Physicians
|January 9, 2025
PubMed
Summary
This summary is machine-generated.

External loop recorder (ELR) screening significantly improves atrial fibrillation detection in older adults at high risk. This method identified 5.5% more new cases of atrial fibrillation compared to usual care.

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Area of Science:

  • Cardiology
  • Primary Care Medicine
  • Medical Diagnostics

Background:

  • The optimal diagnostic strategy for atrial fibrillation (AF) in primary care settings remains uncertain.
  • Community-dwelling older adults with a high CHA2DS2-VASc score are at increased risk for AF.

Purpose of the Study:

  • To evaluate whether external loop recorder (ELR) screening enhances the detection of atrial fibrillation (AF) in community-dwelling adults aged 55 years and older with a CHA2DS2-VASc score greater than two.
  • To compare the efficacy of ELR monitoring versus standard care (pulse screening and ECG) for AF diagnosis in this population.

Main Methods:

  • A randomized cross-over clinical trial design was employed.
  • Participants (n=488) were community-dwelling adults ≥55 years with a CHA2DS2-VASc score >2, suitable for AF screening and anticoagulation.
  • Subjects were randomized to either immediate or delayed 1-week ELR monitoring, with the alternative group receiving usual care (pulse screening/ECG).

Main Results:

  • Atrial fibrillation was detected in 6.6% of participants during the ELR intervention period versus 1% in the usual care period, an absolute difference of 5.53% (P<0.001).
  • The number needed to screen with ELR to detect one additional case of AF was 15.
  • Oral anticoagulation was initiated for all 32 participants diagnosed with AF.

Conclusions:

  • One-week screening with an external loop recorder (ELR) significantly increases the detection rate of new atrial fibrillation (AF) by 5.5% in older, high-risk community-dwelling adults compared to usual care.
  • ELR screening is an effective tool for identifying AF in primary care for individuals with elevated stroke risk.