To Screen or Not to Screen? Examining the Arguments Against Screening for Atrial Fibrillation - 02/08/17

Doi : 10.1016/j.hlc.2017.05.118

Lis Neubeck, PhD, RN, FESC ^a,^c,^f,^⁎ , Jessica Orchard, MPH ^b, Nicole Lowres, PhD ^b,^d, S. Ben Freedman, PhD ^d,^e
^a School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK
^b Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
^c School of Nursing and Midwifery, Faculty of Medicine, Nursing, and Health Sciences, Flinders University, Adelaide, SA, Australia
^d Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
^e Concord Hospital Cardiology, Concord Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
^f Sydney Nursing School, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia

^⁎Corresponding author at: School of Health and Social Care, Room 4.B.20 Sighthill Campus, Edinburgh Napier University, Edinburgh EH11 4BN, Scotland, UK.School of Health and Social CareEdinburgh Napier UniversityEdinburghScotlandUK

Résumé

Atrial fibrillation (AF) is the most common cardiac arrhythmia, with a lifetime risk of one in four of developing AF over the age of 40 years. Around 40% of patients are asymptomatic, which is of concern as AF is a major risk factor for stroke. Early detection and appropriate management reduces stroke risk by two-thirds. Atrial fibrillation screening is now recommended in international guidelines, but there are some common arguments against screening. Overall, to be of value any screening program must fulfil the World Health Organization (WHO) Wilson and Jungner criteria for screening programs. In this paper we address the common arguments, and determine if AF screening fulfils the WHO criteria.

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Keywords : Atrial fibrillation, Screening, Technology

Plan

Background

Argument: “Screen-detected AF is ‘Low Risk”'

Argument: “No Need for Technology”

First Do No Harm

Are The Tests Valid?

Is Screening for AF Really Cost-effective?

Argument: “Screening Not Proven to Prevent Stroke in a Randomised Controlled Trial”

Argument: “Spend Money on Treatment Not Prevention”

Argument: “We Don’t Adequately Manage Those We Already Know About”

Does Screening Meet WHO Criteria?

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Vol 26 - N° 9

P. 880-886 - septembre 2017 Retour au numéro

Article précédent

Epidemiology of Atrial Fibrillation: The Australian and Asia-Pacific Perspective
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To Screen or Not to Screen? Examining the Arguments Against Screening for Atrial Fibrillation - 02/08/17

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