{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:53:12Z","timestamp":1769269992035,"version":"3.49.0"},"reference-count":45,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["NIHR135520"],"award-info":[{"award-number":["NIHR135520"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"<jats:sec id=\"abs1-1\"><jats:title>Background<\/jats:title>\n<jats:p>The indication for this assessment is the use of the KardiaMobile six-lead electrocardiogram device for the assessment of QT interval-based cardiac risk in service users prior to the initiation of, or for the monitoring of, antipsychotic medications, which are associated with an established risk of QT interval prolongation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-2\"><jats:title>Objectives<\/jats:title>\n<jats:p>To provide an early value assessment of whether KardiaMobile six-lead has the potential to provide an effective and safe alternative to 12-lead electrocardiogram for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-3\"><jats:title>Review methods<\/jats:title>\n<jats:p>Twenty-seven databases were searched to April\/May 2022. Review methods followed published guidelines. Where appropriate, study quality was assessed using appropriate risk of bias tools. Results were summarised by research question; accuracy\/technical performance; clinical effects (on cardiac and psychiatric outcomes); service user acceptability\/satisfaction; costs of KardiaMobile six-lead.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-4\"><jats:title>Results<\/jats:title>\n<jats:p>We did not identify any studies which provided information about the diagnostic accuracy of KardiaMobile six-lead, for the detection of corrected QT-interval prolongation, in any population. All studies which reported information about agreement between QT interval measurements (corrected and\/or uncorrected) with KardiaMobile six-lead versus 12-lead electrocardiogram were conducted in non-psychiatric populations, used cardiologists and\/or multiple readers to interpret electrocardiograms. Where reported or calculable, the mean difference in corrected QT interval between devices (12-lead electrocardiogram vs. KardiaMobile six-lead) was generally small (\u2264\u200910 ms) and corrected QT interval measured using KardiaMobile six-lead was consistently lower than that measured using 12-lead electrocardiogram.<\/jats:p>\n<jats:p>All information about the use of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication, was taken from retrospective surveys of staff and service users who had chosen to use KardiaMobile six-lead during pilots, described in two unpublished project reports.<\/jats:p>\n<jats:p>It is important to note that both these project reports relate to pilot studies which were not intended to be used in wider evaluations of KardiaMobile six-lead for use in the NHS.<\/jats:p>\n<jats:p>Both reports included survey results which indicated that the use of KardiaMobile six-lead may be associated with reductions in the time taken to complete an electrocardiogram and costs, relative to 12-lead electrocardiogram, and that KardiaMobile six-lead was preferred over 12-lead electrocardiogram by almost all responding staff and service users.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-5\"><jats:title>Limitations<\/jats:title>\n<jats:p>There was a lack of published evidence about the efficacy of KardiaMobile six-lead for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-6\"><jats:title>Conclusions<\/jats:title>\n<jats:p>There is insufficient evidence to support a full diagnostic assessment evaluating the clinical and cost effectiveness of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication. The evidence to inform the aims of this early value assessment (i.e. to assess whether the device has the potential to be clinically effective and cost-effective) was also limited. This report includes a comprehensive list of research recommendations, both to reduce the uncertainty around this early value assessment and to provide the additional data needed to inform a full diagnostic assessment, including cost-effectiveness modelling.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-7\"><jats:title>Study registration<\/jats:title>\n<jats:p>This study is registered as PROSPERO CRD42022336695.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-8\"><jats:title>Funding<\/jats:title>\n<jats:p>This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135520) and is published in full in <jats:italic>Health Technology Assessment<\/jats:italic>; Vol. 28, No. 19. See the NIHR Funding and Awards website for further award information.<\/jats:p>\n<\/jats:sec>","DOI":"10.3310\/tfhu0078","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T12:18:57Z","timestamp":1711714737000},"page":"1-94","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-0653","authenticated-orcid":true,"given":"Marie","family":"Westwood","sequence":"first","affiliation":[{"name":"Kleijnen Systematic Reviews Ltd, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7443-4798","authenticated-orcid":true,"given":"Nigel","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Kleijnen Systematic Reviews Ltd, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5153-3654","authenticated-orcid":true,"given":"Pawel","family":"Posadzki","sequence":"additional","affiliation":[{"name":"Kleijnen Systematic Reviews Ltd, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0329-4772","authenticated-orcid":true,"given":"Caro","family":"Noake","sequence":"additional","affiliation":[{"name":"Kleijnen Systematic Reviews Ltd, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6221","published-online":{"date-parts":[[2024,3]]},"reference":[{"key":"key2024032917471400_ref3-bib3","volume-title":"Guidelines for the Management of QTc: Prolongation in Adults Prescribed Antipsychotics","author":"NHS Northern England","year":"2017"},{"key":"key2024032917471400_ref4-bib4","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1136\/postgradmedj-2020-138661","article-title":"Managing drug-induced QT prolongation in clinical practice","volume":"97","author":"Khatib","year":"2021","journal-title":"Postgrad Med J"},{"key":"key2024032917471400_ref5-bib5","doi-asserted-by":"crossref","first-page":"161","DOI":"10.15420\/aer.2019.8.3.G1","article-title":"British Heart Rhythm Society clinical practice guidelines on the management of patients developing QT prolongation on antipsychotic medication","volume":"8","author":"Lambiase","year":"2019","journal-title":"Arrhythm Electrophysiol Rev"},{"key":"key2024032917471400_ref7-bib7","volume-title":"Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014","author":"McManus","year":"2016"},{"key":"key2024032917471400_ref9-bib9","doi-asserted-by":"crossref","first-page":"k5354","DOI":"10.1136\/bmj.k5354","article-title":"Treatment resistant depression: what are the options?","volume":"363","author":"McLachlan","year":"2018","journal-title":"BMJ"},{"key":"key2024032917471400_ref12-bib12","volume-title":"StatPearls","author":"Sattar","year":"2021"},{"key":"key2024032917471400_ref13-bib13","volume-title":"Innovation Collaborative: Using Remote ECG Device Technology in the North East and Yorkshire. 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