TY - JOUR
T1 - Self-Reported Mobile Health-Based Risk Factor and CHA(2)DS(2)-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results
AU - Hermans, A.N.L.
AU - Gawalko, M.
AU - Hillmann, H.A.K.
AU - Sohaib, A.
AU - van der Velden, R.M.J.
AU - Betz, K.
AU - Verhaert, D.
AU - Scherr, D.
AU - Meier, J.
AU - Sultan, A.
AU - Steven, D.
AU - Terentieva, E.
AU - Pisters, R.
AU - Hemels, M.
AU - Voorhout, L.
AU - Lodzinski, P.
AU - Krzowski, B.
AU - Gupta, D.
AU - Kozhuharov, N.
AU - Gruwez, H.
AU - Vernooy, K.
AU - Pluymaekers, N.A.H.A.
AU - Hendriks, J.M.
AU - Manninger, M.
AU - Duncker, D.
AU - Linz, D.
AU - TeleCheck-AF investigators
PY - 2022/1/19
Y1 - 2022/1/19
N2 - 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.
AB - 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.
KW - atrial fibrillation
KW - mobile health
KW - photoplethysmography
KW - risk factors
KW - thromboembolic risk
U2 - 10.3389/fcvm.2021.757587
DO - 10.3389/fcvm.2021.757587
M3 - Article
C2 - 35127847
SN - 2297-055X
VL - 8
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 757587
ER -