Study of manual review workload in AF screening
A new study evaluates the manual review workload and strategies to reduce the workload associated with ECG screening, based on results from the SAFER (Screening for Atrial Fibrillation with ECG to Reduce stroke) Feasibility Study.
In the SAFER Feasibility Study, a total of 2141 older adults were asked to record their ECG (using a Zenicor ECG recorder) four times per day for 1–4 weeks, producing 162,515 recordings. The Zenicor medical system, which integrates the Cardiolund ECG Parser software for automated ECG analysis, was used to automatically categorise screening ECGs. Patients with AF were identified by: (i) an algorithm classifying recordings based on signal quality (high or low) and heart rhythm; (ii) a nurse reviewing recordings to correct algorithm misclassifications; and (iii) two cardiologists independently reviewing recordings from patients with any evidence of rhythm abnormality.
The study highlights the importance of an automated algorithm in identifying potentially pathological ECG recordings for review, and vastly reducing the number of manual reviews required. In addition, this study indicates that the workload could be reduced further by using a screening algorithm configuration which only identifies certain pathological recordings for review, whilst still identifying AF patients accurately.
The study is reported in the publication: Screening for Atrial Fibrillation: Improving Efficiency of Manual Review of Handheld Electrocardiograms by Pandiaraja M, Brimicombe J, Cowie M, Dymond A, Lindén HC, Lip GYH, Mant J, Williams K, Charlton PH.; Eng Proc. 2020 Nov 14;2(1):78. PMID: 33778802; PMCID: PMC7610434. DOI: 10.3390/ecsa-7-08195