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Estimated stroke risk, yield, and number needed to screen for atrial fibrillation detected through single time screening: A multicountry patient-level meta-analysis of 141,220 screened individuals

PLoS Medicine Oct 04, 2019

Lowres N, Olivier J, Chao TF, et al. - Researchers from 19 atrial fibrillation screening studies across the world accepted to collaborate and share patient-level data, giving a combined database of 141,220 people screened and 1,539 screen-detected cases of atrial fibrillation to quantify the outcome and stroke risk for atrial fibrillation in 5-year age brackets, revealing the exact connection of how the yield of screening and stroke risk of screen-detected atrial fibrillation progressed with age. The yield of screening was not affected by the screening method used or the enrollment setting, implying that screening programs could be set on the basis of accessible resources. This was the first study to illustrate the specific association of the number that requires to be screened to determine one new atrial fibrillation case or one new atrial fibrillation case in whom anticoagulant treatment was guideline-endorsed, in 5-year age brackets. Thus, people with screen-detected AF are at high calculated stroke risk ie, above age 65, the majority have a Class-1 OAC advice for stroke prevention, and > 70% have ≥ 1 extra stroke risk factor other than age/gender. Moreover, the data exhibits the careful correlation between yield and prognosticated stroke risk profile with age, and strong interdependence for the number needed to screen to recognize one treatable new AF case on the age distribution of the population to be screened ie, fundamental information for precise cost-efficiency calculations.
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