Abstract：
UNASSIGNED: Atrial fibrillation (AF) is often asymptomatic and undiagnosed. As AF and hypertension often coexist, opportunistic AF detection during routine automated blood pressure (BP) measurement appears to be an attractive screening method.
UNASSIGNED: A systematic literature search was conducted to identify studies assessing the diagnostic test accuracy of office, home, or 24-hour ambulatory BP measuring devices with AF detection algorithms versus reference electrocardiography. Analyses were performed per participant (AF status based on several BP readings; most office/home devices) or per reading (AF status based on individual readings; all ambulatory devices). A meta-analysis stratified by device type (office/home/ambulatory) was conducted to calculate pooled measures of diagnostic accuracy. Sensitivity/meta-regression analyses were also performed.
UNASSIGNED: Among 3096 records initially retrieved, 23 diagnostic test accuracy studies were included. Data derived from 11 093 individuals (weighted age 69 years, males 56%, hypertensives 79%, diabetics 24%, and AF prevalence 17%) indicated a pooled sensitivity 0.97 (95% CI, 0.92-0.99), specificity 0.93 (95% CI, 0.90-0.95), and accuracy 0.93 (95% CI, 0.89-0.95), with generally consistent results using office, home, or ambulatory BP devices (slightly lower specificity with the latter). The positive and negative predictive values were 0.70 (95% CI, 0.60-0.80) and 0.99 (95% CI, 0.98-1.00), respectively. Sensitivity analyses indicated lower specificity in studies implementing reading versus participant analyses. Most studies presented a low risk of bias and minor applicability concerns.
UNASSIGNED: There is considerable and consistent evidence suggesting high diagnostic accuracy of AF detection algorithms implemented in automated BP monitors during routine BP measurements in and out of the office. AF diagnosis requires verification (electrocardiography) before treatment is administered.
UNASSIGNED: A systematic literature search was conducted to identify studies assessing the diagnostic test accuracy of office, home, or 24-hour ambulatory BP measuring devices with AF detection algorithms versus reference electrocardiography. Analyses were performed per participant (AF status based on several BP readings; most office/home devices) or per reading (AF status based on individual readings; all ambulatory devices). A meta-analysis stratified by device type (office/home/ambulatory) was conducted to calculate pooled measures of diagnostic accuracy. Sensitivity/meta-regression analyses were also performed.
UNASSIGNED: Among 3096 records initially retrieved, 23 diagnostic test accuracy studies were included. Data derived from 11 093 individuals (weighted age 69 years, males 56%, hypertensives 79%, diabetics 24%, and AF prevalence 17%) indicated a pooled sensitivity 0.97 (95% CI, 0.92-0.99), specificity 0.93 (95% CI, 0.90-0.95), and accuracy 0.93 (95% CI, 0.89-0.95), with generally consistent results using office, home, or ambulatory BP devices (slightly lower specificity with the latter). The positive and negative predictive values were 0.70 (95% CI, 0.60-0.80) and 0.99 (95% CI, 0.98-1.00), respectively. Sensitivity analyses indicated lower specificity in studies implementing reading versus participant analyses. Most studies presented a low risk of bias and minor applicability concerns.
UNASSIGNED: There is considerable and consistent evidence suggesting high diagnostic accuracy of AF detection algorithms implemented in automated BP monitors during routine BP measurements in and out of the office. AF diagnosis requires verification (electrocardiography) before treatment is administered.
摘要：
■心房颤动（AF）通常无症状且未诊断。由于房颤和高血压经常共存，常规自动血压（BP）测量期间的机会性AF检测似乎是一种有吸引力的筛查方法。
■进行了系统的文献检索，以确定评估办公室诊断测试准确性的研究，home,或24小时动态血压测量设备与房颤检测算法和参考心电图。每个参与者(基于多个血压读数的AF状态;大多数办公室/家庭设备)或每个读数(基于个人读数的AF状态;所有移动设备)进行分析。进行了按设备类型（办公室/家庭/门诊）分层的荟萃分析，以计算诊断准确性的汇总指标。还进行了敏感性/荟萃回归分析。
■在最初检索的3096条记录中，包括23项诊断测试准确性研究。数据来自11093名个体(加权年龄69岁，男性56%,高血压患者79%,糖尿病患者24%,房颤患病率17%)表明合并敏感性为0.97(95%CI，0.92-0.99)，特异性0.93（95%CI，0.90-0.95），准确度0.93（95%CI，0.89-0.95），使用Office的结果基本一致，home,或动态血压装置（后者的特异性略低）。阳性预测值和阴性预测值分别为0.70(95%CI,0.60-0.80)和0.99(95%CI,0.98-1.00),分别。敏感性分析表明，在实施阅读与参与者分析的研究中，特异性较低。大多数研究提出了低风险的偏见和轻微的适用性问题。
■有大量一致的证据表明，在办公室内外进行常规血压测量时，自动血压监测仪中实施的AF检测算法具有很高的诊断准确性。AF诊断需要在进行治疗之前进行验证（心电图）。
■进行了系统的文献检索，以确定评估办公室诊断测试准确性的研究，home,或24小时动态血压测量设备与房颤检测算法和参考心电图。每个参与者(基于多个血压读数的AF状态;大多数办公室/家庭设备)或每个读数(基于个人读数的AF状态;所有移动设备)进行分析。进行了按设备类型（办公室/家庭/门诊）分层的荟萃分析，以计算诊断准确性的汇总指标。还进行了敏感性/荟萃回归分析。
■在最初检索的3096条记录中，包括23项诊断测试准确性研究。数据来自11093名个体(加权年龄69岁，男性56%,高血压患者79%,糖尿病患者24%,房颤患病率17%)表明合并敏感性为0.97(95%CI，0.92-0.99)，特异性0.93（95%CI，0.90-0.95），准确度0.93（95%CI，0.89-0.95），使用Office的结果基本一致，home,或动态血压装置（后者的特异性略低）。阳性预测值和阴性预测值分别为0.70(95%CI,0.60-0.80)和0.99(95%CI,0.98-1.00),分别。敏感性分析表明，在实施阅读与参与者分析的研究中，特异性较低。大多数研究提出了低风险的偏见和轻微的适用性问题。
■有大量一致的证据表明，在办公室内外进行常规血压测量时，自动血压监测仪中实施的AF检测算法具有很高的诊断准确性。AF诊断需要在进行治疗之前进行验证（心电图）。
