Comparison of Microlife BP A200 Plus and Omron M6 Blood Pressure Monitors to Detect Atrial Fibrillation in Hypertensive Patients

Marazzi, Giuseppe; Iellamo, Ferdinando; Volterrani, Maurizio; Lombardo, Mauro; Pelliccia, Francesco; Righi, Daniela; Grieco, Fabrizia; Cacciotti, Luca; Iaia, Luigi; Caminiti, Giuseppe; Rosano, Giuseppe

doi:10.1007/s12325-011-0087-0

Cited by 64 publications

(84 citation statements)

References 14 publications

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“…There were 10 studies with a single set of inclusion criteria (cohort or one-gate studies), 19,60,[63][64][65][66][67][68][69] three studies with two sets of inclusion criteria (case-control or two-gate studies) [70][71][72] and two studies of unclear design. 73,74 One of the case-control studies grouped participants into those with known sustained AF, those with other non-AF arrhythmias and those in sinus rhythm.…”

Section: Methodsmentioning

confidence: 99%

“…Reasons for exclusion were that the study was not a DTA study; that the target condition was not AF (this included studies in which DTA data for AF could not be extracted, for example when AF and atrial flutter were combined); that the information was not per person (i.e. the unit of analysis was not the person, for example the unit of analysis was the reading or the segment of a reading); population reasons (people Four studies awaiting assessment (see Table 1 Seventeen publications 19,36,[60][61][62][63][64][65][66][67][68][69][70][71][72][73][74] (15 studies) containing 56 comparisons of an index test with the reference standard were found to meet the full set of eligibility criteria and were included in the review. One publication contained two eligible studies.…”

Section: Study Selectionmentioning

confidence: 99%

“…19,36,61 One study also had an erratum published. 62,63 In addition, four potentially relevant DTA studies were identified ( Table 1); these trials are awaiting assessment against our eligibility criteria as study reports and results were not identified.…”

Section: Study Selectionmentioning

confidence: 99%

“…19,67,70,72 The other studies were performed in outpatient settings (hypertension outpatients, 63 ]. In one study the setting was unclear (a computerised electrocardiographic system).…”

Section: Population and Settingmentioning

confidence: 99%

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Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis

Welton

McAleenan

Thom

et al. 2017

Health Technol Assess

122

116

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BackgroundAtrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources.ObjectivesTo conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model.DesignSystematic review, meta-analysis and cost-effectiveness analysis.SettingPrimary care.ParticipantsAdults.InterventionScreening strategies, defined by screening test, age at initial and final screens, screening interval and format of screening {systematic opportunistic screening [individuals offered screening if they consult with their general practitioner (GP)] or systematic population screening (when all eligible individuals are invited to screening)}.Main outcome measuresSensitivity, specificity and diagnostic odds ratios; the odds ratio of detecting new AF cases compared with no screening; and the mean incremental net benefit compared with no screening.Review methodsTwo reviewers screened the search results, extracted data and assessed the risk of bias. A DTA meta-analysis was perfomed, and a decision tree and Markov model was used to evaluate the cost-effectiveness of the screening strategies.ResultsDiagnostic test accuracy depended on the screening test and how it was interpreted. In general, the screening tests identified in our review had high sensitivity (> 0.9). Systematic population and systematic opportunistic screening strategies were found to be similarly effective, with an estimated 170 individuals needed to be screened to detect one additional AF case compared with no screening. Systematic opportunistic screening was more likely to be cost-effective than systematic population screening, as long as the uptake of opportunistic screening observed in randomised controlled trials translates to practice. Modified blood pressure monitors, photoplethysmography or nurse pulse palpation were more likely to be cost-effective than other screening tests. A screening strategy with an initial screening age of 65 years and repeated screens every 5 years until age 80 years was likely to be cost-effective, provided that compliance with treatment does not decline with increasing age.ConclusionsA national screening programme for AF is likely to represent a cost-effective use of resources. Systematic opportunistic screening is more likely to be cost-effective than systematic population screening. Nurse pulse palpation or modified blood pressure monitors would be appropriate screening tests, with confirmation by diagnostic 12-lead electrocardiography interpreted by a trained GP, with referral to a specialist in the case of an unclear diagnosis. Implementation strategies to operationalise uptake of systematic opportunistic screening in primary care should accompany any screening recommendations.LimitationsMany inputs for the economic model relied on a single trial [the Screening for Atrial Fibrillation in the Elderly (SAFE) study] and DTA results were based on a few studies at high risk of bias/of low applicability.Future workComparative studies measuring long-term outcomes of screening strategies and DTA studies for new, emerging technologies and to replicate the results for photoplethysmography and GP interpretation of 12-lead electrocardiography in a screening population.Study registrationThis study is registered as PROSPERO CRD42014013739.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Methodsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

“…19,67,70,72 The other studies were performed in outpatient settings (hypertension outpatients, 63 ]. In one study the setting was unclear (a computerised electrocardiographic system).…”

Section: Population and Settingmentioning

confidence: 99%

See 2 more Smart Citations

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis

Welton

McAleenan

Thom

et al. 2017

Health Technol Assess

122

116

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“…Of course, it may lead to either starting or not starting antihypertensive medication depending on the choice of the device of the studied manufacturers. On the other hand, no differences were observed between measured BP using Omron or Microlife devices in a recent study with focus on the detection of atrial fibrillation in hypertensive patients [16]. Kewalbansing et al [17] compared Omron HEM-SOLAR and Microlife BP3AS1-2 in Surinam and found that Microlife device underestimated systolic BP when compared with Omron and sphygmomanometer.…”

Section: Discussionmentioning

confidence: 97%

The Choice of Home Blood Pressure Monitoring Device Matters: Differences between Three Commercial Monitors Used in Finnish General Practice

Kantola¹

2013

J Gen Pract

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Objectives: The use of home blood pressure measurement in the follow-up of antihypertensive treatment is rapidly increasing. Published non-commercial comparisons or validation studies between different types of home monitors have been rare. We describe here the results from a study in which three home blood pressure monitors from two manufacturers were compared.Methods: Three different upper arm automatic blood pressure measuring devices: Microlife BP 3AC 1-1, Microlife BP3AG1 and Omron M4-I were compared in a randomized study. It was carried out among 65 Finnish normo-and hypertensive people who used all three devices at home for one-week of blood pressure monitoring and measured their blood pressure twice both in the morning and in the evening.Results: An about 2 mm Hg difference in systolic, diastolic and mean pressure was observed between Omron M4-I and the Microlife devices whereas the Microlife devices showed equal performance. A significant correlation in the mean pressure was observed between all three devices. Conclusions:Although all these devices have passed the British Hypertension Society (BHS) qualification, the blood pressure monitoring results in this study showed that there may be a small blood pressure difference between the devices from separate manufacturers. Blood pressure monitoring results are most reliable when the same device is used consistently.

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Screening for Atrial Fibrillation

Kahwati

Asher

Kadro

et al. 2022

JAMA

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Comparison of Microlife BP A200 Plus and Omron M6 Blood Pressure Monitors to Detect Atrial Fibrillation in Hypertensive Patients

Cited by 64 publications

References 14 publications

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis

Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis

The Choice of Home Blood Pressure Monitoring Device Matters: Differences between Three Commercial Monitors Used in Finnish General Practice

Screening for Atrial Fibrillation

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