{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T02:10:48Z","timestamp":1781316648207,"version":"3.54.1"},"reference-count":30,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,1,23]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the diagnostic performance of a UK National Institute for Health and Care Excellence-recommended automatic oscillometric blood pressure (BP) measurement device incorporated with an atrial fibrillation (AF) detection algorithm (Microlife WatchBP Home A) for real-world AF screening in a primary healthcare setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Primary healthcare setting in Hong Kong.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>This was a prospective AF screening study carried out between 1 September 2014 and 14 January 2015. The Microlife device was evaluated for AF detection and compared with a reference standard of lead-I ECG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome measures<\/jats:title>\n                  <jats:p>Diagnostic performance of Microlife for AF detection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>5969 patients (mean age: 67.2\u00b111.0 years; 53.9% female) were recruited. The mean CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc (<jats:bold>\n                        <jats:underline>C<\/jats:underline>\n                     <\/jats:bold>: congestive heart failure [1 point]; <jats:bold>\n                        <jats:underline>H<\/jats:underline>\n                     <\/jats:bold>: hypertension [1 point]; <jats:bold>\n                        <jats:underline>A<jats:sub>2<\/jats:sub>\n                        <\/jats:underline>\n                     <\/jats:bold>: age 65-74 years [1 point] and age \u226575 years [2 points]; <jats:bold>\n                        <jats:underline>D<\/jats:underline>\n                     <\/jats:bold>: diabetes mellitus [1 point]; <jats:bold>\n                        <jats:underline>S<\/jats:underline>\n                     <\/jats:bold>: prior stroke or transient ischemic attack [2 points]; <jats:bold>\n                        <jats:underline>VA<\/jats:underline>\n                     <\/jats:bold>: vascular disease [1 point]; and <jats:bold>\n                        <jats:underline>Sc<\/jats:underline>\n                     <\/jats:bold>: sex category [female] [1 point])score was 2.8\u00b11.3. AF was diagnosed in 72 patients (1.21%) and confirmed by a 12-lead ECG. The Microlife device correctly identified AF in 58 patients and produced 79 false-positives. The corresponding sensitivity and specificity for AF detection were 80.6% (95% CI 69.5 to 88.9) and 98.7% (95% CI 98.3 to 98.9), respectively. Among patients with a false-positive by the Microlife device, 30.4% had sinus rhythm, 35.4% had sinus arrhythmia and 29.1% exhibited premature atrial complexes. With the low prevalence of AF in this population, the positive and negative predictive values of Microlife device for AF detection were 42.4% (95% CI 34.0 to 51.2) and 99.8% (95% CI 99.6 to 99.9), respectively. The overall diagnostic performance of Microlife device to detect AF as determined by area under the curves was 0.90 (95% CI 0.89 to 0.90).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In the primary care setting, Microlife WatchBP Home was an effective means to screen for AF, with a reasonable sensitivity of 80.6% and a high negative predictive value of 99.8%, in addition to its routine function of BP measurement. In a younger patient population aged &lt;65 years with a lower prevalence of AF, Microlife WatchBP Home A demonstrated a similar diagnostic accuracy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013685","type":"journal-article","created":{"date-parts":[[2017,6,15]],"date-time":"2017-06-15T20:20:10Z","timestamp":1497558010000},"page":"e013685","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Diagnostic performance of an automatic blood pressure measurement device, Microlife WatchBP Home A, for atrial fibrillation screening in a real-world primary care setting"],"prefix":"10.1136","volume":"7","author":[{"given":"Pak-Hei","family":"Chan","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Ka","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Pun","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Fai","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Man-Ying","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Wai-Sing","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Wah","family":"Siu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,6,15]]},"reference":[{"key":"2025101814054457000_7.6.e013685.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"2025101814054457000_7.6.e013685.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.14.5.664"},{"key":"2025101814054457000_7.6.e013685.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.04.021"},{"key":"2025101814054457000_7.6.e013685.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006070"},{"key":"2025101814054457000_7.6.e013685.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs253"},{"key":"2025101814054457000_7.6.e013685.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39280.660567.55"},{"key":"2025101814054457000_7.6.e013685.7","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2009.98"},{"key":"2025101814054457000_7.6.e013685.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-004565","article-title":"Triage tests for identifying atrial fibrillation in primary care: a diagnostic accuracy study comparing single-lead ECG and modified BP monitors","volume":"4","author":"Kearley","year":"2014","journal-title":"BMJ Open"},{"key":"2025101814054457000_7.6.e013685.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.07.016"},{"key":"2025101814054457000_7.6.e013685.10","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2009.5"},{"key":"2025101814054457000_7.6.e013685.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2004.00499.x"},{"key":"2025101814054457000_7.6.e013685.12","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1007\/s10072-015-2231-0","article-title":"Validation of a simple method for atrial fibrillation screening in patients with stroke","volume":"36","author":"Gandolfo","year":"2015","journal-title":"Neurol Sci"},{"key":"2025101814054457000_7.6.e013685.13","unstructured":"Garabelli P , Albert D , Reynolds D . Accuracy and novelty of an inexpensive iPhone-based event recorder. Heart Rhythm Scientific Sessions 2012."},{"key":"2025101814054457000_7.6.e013685.14","doi-asserted-by":"crossref","first-page":"295","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 Haemost"},{"key":"2025101814054457000_7.6.e013685.15","first-page":"000","article-title":"AHA\/ACC\/HRS Guideline for the management of patients with Atrial Fibrillation","volume":"2014","author":"January","year":"2014","journal-title":"Circulation"},{"key":"2025101814054457000_7.6.e013685.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61514-6"},{"key":"2025101814054457000_7.6.e013685.17","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-146-12-200706190-00007"},{"key":"2025101814054457000_7.6.e013685.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60443-8"},{"key":"2025101814054457000_7.6.e013685.19","doi-asserted-by":"crossref","first-page":"iii-iv, ix-x, 1-74","DOI":"10.3310\/hta9400","article-title":"A randomised controlled trial and cost-effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in people aged 65 and over. the SAFE study","volume":"9","author":"Hobbs","year":"2005","journal-title":"Health Technol Assess"},{"key":"2025101814054457000_7.6.e013685.20","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-011-0087-0"},{"key":"2025101814054457000_7.6.e013685.21","doi-asserted-by":"publisher","DOI":"10.1586\/erd.12.46"},{"key":"2025101814054457000_7.6.e013685.22","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s40258-014-0096-7","article-title":"WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension: a NICE Medical Technology Guidance","volume":"12","author":"Willits","year":"2014","journal-title":"Appl Health Econ Health Policy"},{"key":"2025101814054457000_7.6.e013685.23","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.ijcard.2015.10.182","article-title":"Screening for atrial fibrillation with automated blood pressure measurement: research evidence and practice recommendations","volume":"203","author":"Verberk","year":"2016","journal-title":"Int J Cardiol"},{"key":"2025101814054457000_7.6.e013685.24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004565"},{"key":"2025101814054457000_7.6.e013685.25","first-page":"315","article-title":"iPhone ECG screening by practice nurses and receptionists for atrial fibrillation in general practice: the GP-SEARCH qualitative pilot study","volume":"43","author":"Orchard","year":"2014","journal-title":"Aust Fam Physician"},{"key":"2025101814054457000_7.6.e013685.26","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014343"},{"key":"2025101814054457000_7.6.e013685.27","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024439"},{"key":"2025101814054457000_7.6.e013685.28","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g3655"},{"key":"2025101814054457000_7.6.e013685.29","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"2025101814054457000_7.6.e013685.30","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE2008021"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013685","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:05:56Z","timestamp":1760821556000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2017,6,15]]},"published-print":{"date-parts":[[2017,6]]}},"alternative-id":["10.1136\/bmjopen-2016-013685"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013685","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]}}}