Assessing the reliability of MyDiagnostick in AF detection among Asian populations

21 Aug 2023

The arsenal of atrial fibrillation (AF) screening tools continues to expand due to the rapid advancement of mobile health technologies.1 Despite the lack of clinical validation of many of these tools, their usage is justified by their responsiveness and reliability in AF detection.1 A prime example of these AF screening tools is MyDiagnostick (Applied Biomedical Systems BV, Maastricht, The Netherlands), which allows users to record a single-lead electrocardiography (ECG) by holding the electrodes on both ends of the device.2 A previous study conducted in Belgium has concluded that MyDiagnostick exhibited exceptional AF diagnostic accuracy, with sensitivity and specificity of 94% and 93%, respectively.2 Nevertheless, the effectiveness of MyDiagnostick has yet to be validated among the Asian population, hence, a  recent study was conducted to investigate its performance in the Asian general population.3

A prospective single-center study was conducted to evaluate the reliability of MyDiagnostick in AF screening among the Asian population.3 A total of 671 patients were recruited for AF screening, with Chinese participants making up the majority (79%), followed by Malaysians (7%) and Indians (11%).3 The participants first completed a questionnaire, then underwent a manual pulse check for at least 15 seconds.3 Subsequently, they were screened with MyDiagnostick.3 Confirmatory single-lead ECG was performed on participants who got an abnormal result during manual pulse check or MyDiagnostick screening.3 The primary objective of this study was to assess the diagnostic accuracy of MyDiagnostick against manual pulse checks in a low-risk Asian population, while the secondary objective was to identify the characteristics of participants with detected AF.3

The results indicated an AF prevalence rate of 1.78% among the study population, with 50% of these participants being newly diagnosed.3 MyDiagnostick showed a sensitivity of 100%  (95% CI: 73.5%-100.0%) and a specificity of 96.2% (95% CI: 94.6%-97.6%).3 However, out of the participants who obtained an abnormal MyDiagnostick result (n=37), only 32.4% (95% CI:  24.6%-41.3%) of participants were diagnosed with AF after undergoing confirmatory single-lead ECG.3 In comparison, manual pulse checks had a sensitivity of 83.3% (95% CI: 51.3%-97.9%) and specificity of 98.9% (95% CI: 97.8%-99.5%), with a positive  predictive value (PPV) of 58.8% (95% CI: 39.5%-75.6%).3 Despite the observable difference in sensitivity, specificity and PPV between the 2 screening methods, a statistical significance was not established owing to the limited sample size.3

In this study, serval characteristics were observed among the  participants with AF.3 They were generally older (72.0 ± 11.7 vs.  56.0 ± 13.0; p<0.0001) and had a relatively higher CHADSVASC risk score (2.9 ± 1.5 vs. 1.5 ± 1.1; p=0.0001).3 The higher CHADSVASC risk scores were likely attributed to the higher prevalence of  hypertension among participants with AF (66.0% vs. 33.0%; p=0.016).3

To conclude, MyDiagnostick exhibited exemplary sensitivity and specificity in AF detection among the Asian populations, which is comparable to other related studies performed in different population cohorts.3 Despite a numerically lower PPV compared with a manual pulse check, MyDiagnostick can be performed by non-medical personnel.3 As such, this makes MyDiagnostick an ideal screening tool for primary care settings, also allowing similar AF screenings to be performed in clinics.3

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