{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:32:20Z","timestamp":1788957140586,"version":"build-2803163510"},"reference-count":37,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Sleep Medicine"],"published-print":{"date-parts":[[2021,9]]},"DOI":"10.1016\/j.sleep.2021.07.014","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T11:32:50Z","timestamp":1626521570000},"page":"166-171","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"special_numbering":"C","title":["Transfer learning artificial intelligence for automated detection of atrial fibrillation in patients undergoing evaluation for suspected obstructive sleep apnoea: a feasibility study"],"prefix":"10.1016","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4230-0602","authenticated-orcid":false,"given":"Nestor","family":"Gahungu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsin","family":"Shariar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Playford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0646-2989","authenticated-orcid":false,"given":"Christopher","family":"Judkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Gabbay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"8","key":"10.1016\/j.sleep.2021.07.014_bib1","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1161\/CIRCULATIONAHA.113.005119","article-title":"Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study","volume":"129","author":"Chugh","year":"2014","journal-title":"Circulation"},{"issue":"8532","key":"10.1016\/j.sleep.2021.07.014_bib2","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/S0140-6736(87)90174-7","article-title":"Risk of stroke in non-rheumatic atrial fibrillation","volume":"1","author":"Flegel","year":"1987","journal-title":"Lancet (London, England)"},{"issue":"10","key":"10.1016\/j.sleep.2021.07.014_bib3","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1212\/WNL.28.10.973","article-title":"Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study","volume":"28","author":"Wolf","year":"1978","journal-title":"Neurology"},{"issue":"5","key":"10.1016\/j.sleep.2021.07.014_bib4","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S0002-9343(02)01236-6","article-title":"A\u00a0population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew\/Paisley study","volume":"113","author":"Stewart","year":"2002","journal-title":"Am J Med"},{"issue":"5","key":"10.1016\/j.sleep.2021.07.014_bib5","doi-asserted-by":"crossref","first-page":"448.e1","DOI":"10.1016\/j.amjmed.2005.10.057","article-title":"Quality of life in patients with atrial fibrillation: a systematic review","volume":"119","author":"Thrall","year":"2006","journal-title":"Am J Med"},{"issue":"4","key":"10.1016\/j.sleep.2021.07.014_bib6","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/S1474-4422(15)70027-X","article-title":"Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis","volume":"14","author":"Sposato","year":"2015","journal-title":"Lancet Neurol"},{"issue":"10","key":"10.1016\/j.sleep.2021.07.014_bib7","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1161\/01.STR.27.10.1760","article-title":"Stroke severity in atrial fibrillation. The Framingham Study","volume":"27","author":"Lin","year":"1996","journal-title":"Stroke"},{"issue":"8","key":"10.1016\/j.sleep.2021.07.014_bib8","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1161\/CIRCULATIONAHA.112.126656","article-title":"Stepwise screening of atrial fibrillation in a 75-year-old population: implications for stroke prevention","volume":"127","author":"Engdahl","year":"2013","journal-title":"Circulation"},{"issue":"6","key":"10.1016\/j.sleep.2021.07.014_bib9","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1160\/TH14-03-0231","article-title":"Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. The SEARCH-AF study","volume":"111","author":"Lowres","year":"2014","journal-title":"Thromb Haemostasis"},{"issue":"25","key":"10.1016\/j.sleep.2021.07.014_bib10","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1161\/CIRCULATIONAHA.114.014343","article-title":"Mass screening for untreated atrial fibrillation: the STROKESTOP study","volume":"131","author":"Svennberg","year":"2015","journal-title":"Circulation"},{"issue":"8","key":"10.1016\/j.sleep.2021.07.014_bib11","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1164\/rccm.200509-1442OC","article-title":"Association of nocturnal arrhythmias with sleep-disordered breathing: the sleep heart health study","volume":"173","author":"Mehra","year":"2006","journal-title":"Am J Respir Crit Care Med"},{"issue":"9","key":"10.1016\/j.sleep.2021.07.014_bib12","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1093\/sleep\/20.9.705","article-title":"Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women","volume":"20","author":"Young","year":"1997","journal-title":"Sleep"},{"issue":"5","key":"10.1016\/j.sleep.2021.07.014_bib13","first-page":"246","article-title":"Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study","volume":"108","author":"Young","year":"2009","journal-title":"Wis Med J: Off Publ State Med Soc Wis"},{"issue":"35","key":"10.1016\/j.sleep.2021.07.014_bib14","doi-asserted-by":"crossref","first-page":"2746","DOI":"10.1093\/eurheartj\/eht280","article-title":"Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060","volume":"34","author":"Krijthe","year":"2013","journal-title":"Eur Heart J"},{"issue":"19","key":"10.1016\/j.sleep.2021.07.014_bib15","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1056\/NEJMoa043104","article-title":"Obstructive sleep apnea as a risk factor for stroke and death","volume":"353","author":"Yaggi","year":"2005","journal-title":"N\u00a0Engl J Med"},{"issue":"9","key":"10.1016\/j.sleep.2021.07.014_bib16","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1161\/01.STR.0000236560.15735.0f","article-title":"Severe sleep apnea and risk of ischemic stroke in the elderly","volume":"37","author":"Munoz","year":"2006","journal-title":"Stroke"},{"issue":"26","key":"10.1016\/j.sleep.2021.07.014_bib17","doi-asserted-by":"crossref","first-page":"2467","DOI":"10.1056\/NEJMoa1311376","article-title":"Atrial fibrillation in patients with cryptogenic stroke","volume":"370","author":"Gladstone","year":"2014","journal-title":"N\u00a0Engl J Med"},{"issue":"6","key":"10.1016\/j.sleep.2021.07.014_bib18","first-page":"829","article-title":"The association between nocturnal cardiac arrhythmias and sleep-disordered breathing: the DREAM study","volume":"12","author":"Selim","year":"2016","journal-title":"J\u00a0Clin Sleep Med: JCSM: Off Publ Am Acad Sleep Med"},{"issue":"5","key":"10.1016\/j.sleep.2021.07.014_bib19","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jacc.2006.08.060","article-title":"Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation","volume":"49","author":"Gami","year":"2007","journal-title":"J\u00a0Am Coll Cardiol"},{"issue":"19","key":"10.1016\/j.sleep.2021.07.014_bib20","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.jacc.2009.06.038","article-title":"Triggering of nocturnal arrhythmias by sleep-disordered breathing events","volume":"54","author":"Monahan","year":"2009","journal-title":"J\u00a0Am Coll Cardiol"},{"issue":"10201","key":"10.1016\/j.sleep.2021.07.014_bib21","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/S0140-6736(19)31721-0","article-title":"An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction","volume":"394","author":"Attia","year":"2019","journal-title":"Lancet (London, England)"},{"issue":"1","key":"10.1016\/j.sleep.2021.07.014_bib22","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1038\/s41467-020-15432-4","article-title":"Automatic diagnosis of the 12-lead ECG using a deep neural network","volume":"11","author":"Ribeiro","year":"2020","journal-title":"Nat Commun"},{"issue":"12","key":"10.1016\/j.sleep.2021.07.014_bib23","first-page":"1191","article-title":"The 1975 declaration of Helsinki and consent","volume":"115","author":"Shephard","year":"1976","journal-title":"Can Med Assoc J"},{"issue":"5","key":"10.1016\/j.sleep.2021.07.014_bib24","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1109\/TMI.2016.2528162","article-title":"Deep convolutional neural networks for computer-aided detection: CNN architectures, dataset characteristics and transfer learning","volume":"35","author":"Shin","year":"2016","journal-title":"IEEE Trans Med Imag"},{"issue":"4","key":"10.1016\/j.sleep.2021.07.014_bib25","first-page":"203","article-title":"Measures of diagnostic accuracy: basic definitions","volume":"19","author":"\u0160imundi\u0107","year":"2009","journal-title":"EJIFCC"},{"issue":"1","key":"10.1016\/j.sleep.2021.07.014_bib26","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2018-000942","article-title":"Diagnostic accuracies of screening for atrial fibrillation by cardiac nurses versus radiographers","volume":"6","author":"Kvist","year":"2019","journal-title":"Open Heart"},{"issue":"2","key":"10.1016\/j.sleep.2021.07.014_bib27","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s12410-020-9529-x","article-title":"Current challenges and recent updates in artificial intelligence and echocardiography","volume":"13","author":"Gahungu","year":"2020","journal-title":"Curr Cardiovasc Imaging Rep"},{"issue":"1","key":"10.1016\/j.sleep.2021.07.014_bib28","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/s41746-017-0013-1","article-title":"Fast and accurate view classification of echocardiograms using deep learning","volume":"1","author":"Madani","year":"2018","journal-title":"NPJ Digit Med"},{"issue":"9","key":"10.1016\/j.sleep.2021.07.014_bib29","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1136\/heartjnl-2019-316004","article-title":"Accuracy of a smartwatch based single-lead electrocardiogram device in detection of atrial fibrillation","volume":"106","author":"Rajakariar","year":"2020","journal-title":"Heart"},{"issue":"2","key":"10.1016\/j.sleep.2021.07.014_bib30","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1378\/chest.106.2.466","article-title":"Cardiac arrhythmias, snoring, and sleep apnea","volume":"106","author":"Hoffstein","year":"1994","journal-title":"Chest"},{"issue":"3","key":"10.1016\/j.sleep.2021.07.014_bib31","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/j.1365-2869.2008.00726.x","article-title":"Continuous positive airway pressure treatment for obstructive sleep apnoea reduces resting heart rate but does not affect dysrhythmias: a randomised controlled trial","volume":"18","author":"Craig","year":"2009","journal-title":"J\u00a0Sleep Res"},{"issue":"suppl 3","key":"10.1016\/j.sleep.2021.07.014_bib32","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1136\/thx.53.2008.S29","article-title":"Heart block in patients with sleep apnoea","volume":"53","author":"Becker","year":"1998","journal-title":"Thorax"},{"issue":"19","key":"10.1016\/j.sleep.2021.07.014_bib33","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1161\/CIRCULATIONAHA.117.030583","article-title":"Assessment of remote heart rhythm sampling using the AliveCor heart monitor to screen for atrial fibrillation: the REHEARSE-AF study","volume":"136","author":"Halcox","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.sleep.2021.07.014_bib34","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.sleep.2019.01.036","article-title":"Advances in screening for undiagnosed atrial fibrillation for stroke prevention and implications for patients with obstructive sleep apnoea: a literature review and research agenda","volume":"57","author":"Gahungu","year":"2019","journal-title":"Sleep Med"},{"issue":"5","key":"10.1016\/j.sleep.2021.07.014_bib35","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3109\/07853899509002462","article-title":"Artificial neural networks for decision support in clinical medicine","volume":"27","author":"Forsstrom","year":"1995","journal-title":"Ann Med"},{"issue":"7553","key":"10.1016\/j.sleep.2021.07.014_bib36","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1038\/nature14539","article-title":"Deep learning","volume":"521","author":"LeCun","year":"2015","journal-title":"Nature"},{"issue":"12","key":"10.1016\/j.sleep.2021.07.014_bib37","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11886-018-1074-8","article-title":"Machine meets biology: a primer on artificial intelligence in cardiology and cardiac imaging","volume":"20","author":"Dilsizian","year":"2018","journal-title":"Curr Cardiol Rep"}],"container-title":["Sleep Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945721003968?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945721003968?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T15:34:14Z","timestamp":1761406454000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1389945721003968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":37,"alternative-id":["S1389945721003968"],"URL":"https:\/\/doi.org\/10.1016\/j.sleep.2021.07.014","relation":{},"ISSN":["1389-9457"],"issn-type":[{"value":"1389-9457","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Transfer learning artificial intelligence for automated detection of atrial fibrillation in patients undergoing evaluation for suspected obstructive sleep apnoea: a feasibility study","name":"articletitle","label":"Article Title"},{"value":"Sleep Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.sleep.2021.07.014","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Published by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}