TY - JOUR

T1 - Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation

T2 - TeleCheck-AF Results

AU - Hermans, Astrid N. L.

AU - Gawalko, Monika

AU - Hillmann, Henrike A. K.

AU - Sohaib, Afzal

AU - van der Velden, Rachel M. J.

AU - Betz, Konstanze

AU - Verhaert, Dominique

AU - Scherr, Daniel

AU - Meier, Julia

AU - Sultan, Arian

AU - Steven, Daniel

AU - Terentieva, Elena

AU - Pisters, Ron

AU - Hemels, Martin

AU - Voorhout, Leonard

AU - Lodzinski, Piotr

AU - Krzowski, Bartosz

AU - Gupta, Dhiraj

AU - Kozhuharov, Nikola

AU - Gruwez, Henri

AU - Vernooy, Kevin

AU - Pluymaekers, Nikki A. H. A.

AU - Hendriks, Jeroen M.

AU - Manninger, Martin

AU - Duncker, David

AU - Linz, Dominik

AU - TeleCheck-AF investigators

PY - 2022

Y1 - 2022

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 - Journal article

C2 - 35127847

VL - 8

JO - Frontiers in Cardiovascular Medicine

JF - Frontiers in Cardiovascular Medicine

SN - 2297-055X

M1 - 757587

ER -