Self-Reported Mobile Health-Based Risk Factor and CHA(2)DS(2)-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results

A.N.L. Hermans, M. Gawalko, H.A.K. Hillmann, A. Sohaib, R.M.J. van der Velden, K. Betz, D. Verhaert, D. Scherr, J. Meier, A. Sultan, D. Steven, E. Terentieva, R. Pisters, M. Hemels, L. Voorhout, P. Lodzinski, B. Krzowski, D. Gupta, N. Kozhuharov, H. GruwezK. Vernooy, N.A.H.A. Pluymaekers, J.M. Hendriks, M. Manninger, D. Duncker, D. Linz*, TeleCheck-AF investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

IntroductionThe TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA(2)DS(2)-VASc-score in atrial fibrillation (AF) patients managed within this approach. Materials and MethodsConsecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA(2)DS(2)-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR). ResultsAmong 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or >= 80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%-overtreated. ConclusionSelf-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA(2)DS(2)-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.
Original languageEnglish
Article number757587
Number of pages9
JournalFrontiers in cardiovascular medicine
Volume8
DOIs
Publication statusPublished - 19 Jan 2022

Keywords

  • atrial fibrillation
  • mobile health
  • photoplethysmography
  • risk factors
  • thromboembolic risk

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