Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results

Astrid N.L. Hermans; Monika Gawałko; Henrike A.K. Hillmann; Afzal Sohaib; Rachel M.J. van der Velden; Konstanze Betz; Dominique Verhaert; Daniel Scherr; Julia Meier; Arian Sultan; Daniel Steven; Elena Terentieva; Ron Pisters; Martin Hemels; Leonard Voorhout; Piotr Lodziński; Bartosz Krzowski; Dhiraj Gupta; Nikola Kozhuharov; Henri Gruwez; Kevin Vernooy; Nikki A.H.A. Pluymaekers; Jeroen M. Hendriks; Martin Manninger; David Duncker; Dominik Linz

doi:10.3389/fcvm.2021.757587

Self-Reported Mobile Health-Based Risk Factor and CHA₂DS₂-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results

Astrid N.L. Hermans, Monika Gawałko, Henrike A.K. Hillmann, Afzal Sohaib, Rachel M.J. van der Velden, Konstanze Betz, Dominique Verhaert, Daniel Scherr, Julia Meier, Arian Sultan, Daniel Steven, Elena Terentieva, Ron Pisters, Martin Hemels, Leonard Voorhout, Piotr Lodziński, Bartosz Krzowski, Dhiraj Gupta, Nikola Kozhuharov, Henri GruwezKevin Vernooy, Nikki A.H.A. Pluymaekers, Jeroen M. Hendriks, Martin Manninger, David Duncker, Dominik Linz

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Abstract

Introduction: The TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA₂DS₂-VASc-score in atrial fibrillation (AF) patients managed within this approach. Materials and Methods: Consecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA₂DS₂-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR). Results: Among 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%—overtreated. Conclusion: Self-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA₂DS₂-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.

Original language	English
Article number	757587
Number of pages	9
Journal	Frontiers in Cardiovascular Medicine
Volume	8
DOIs	https://doi.org/10.3389/fcvm.2021.757587
Publication status	Published - 19 Jan 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

atrial fibrillation
mobile health
photoplethysmography
risk factors
thromboembolic risk

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10.3389/fcvm.2021.757587Licence: CC BY

Published versionFinal published version, 811 KBLicence: CC BY

Cite this

Hermans, A. N. L., Gawałko, M., Hillmann, H. A. K., Sohaib, A., van der Velden, R. M. J., Betz, K., Verhaert, D., Scherr, D., Meier, J., Sultan, A., Steven, D., Terentieva, E., Pisters, R., Hemels, M., Voorhout, L., Lodziński, P., Krzowski, B., Gupta, D., Kozhuharov, N., ... Linz, D. (2022). Self-Reported Mobile Health-Based Risk Factor and CHA₂DS₂-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results. Frontiers in Cardiovascular Medicine, 8, Article 757587. https://doi.org/10.3389/fcvm.2021.757587

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title = "Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results",

abstract = "Introduction: The TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA2DS2-VASc-score in atrial fibrillation (AF) patients managed within this approach. Materials and Methods: Consecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA2DS2-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR). Results: Among 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%—overtreated. Conclusion: Self-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA2DS2-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.",

keywords = "atrial fibrillation, mobile health, photoplethysmography, risk factors, thromboembolic risk",

author = "Hermans, {Astrid N.L.} and Monika Gawa{\l}ko and Hillmann, {Henrike A.K.} and Afzal Sohaib and {van der Velden}, {Rachel M.J.} and Konstanze Betz and Dominique Verhaert and Daniel Scherr and Julia Meier and Arian Sultan and Daniel Steven and Elena Terentieva and Ron Pisters and Martin Hemels and Leonard Voorhout and Piotr Lodzi{\'n}ski and Bartosz Krzowski and Dhiraj Gupta and Nikola Kozhuharov and Henri Gruwez and Kevin Vernooy and Pluymaekers, {Nikki A.H.A.} and Hendriks, {Jeroen M.} and Martin Manninger and David Duncker and Dominik Linz",

year = "2022",

month = jan,

day = "19",

doi = "10.3389/fcvm.2021.757587",

language = "English",

volume = "8",

journal = "Frontiers in Cardiovascular Medicine",

issn = "2297-055X",

publisher = "Frontiers Media S.A.",

}

Hermans, ANL, Gawałko, M, Hillmann, HAK, Sohaib, A, van der Velden, RMJ, Betz, K, Verhaert, D, Scherr, D, Meier, J, Sultan, A, Steven, D, Terentieva, E, Pisters, R, Hemels, M, Voorhout, L, Lodziński, P, Krzowski, B, Gupta, D, Kozhuharov, N, Gruwez, H, Vernooy, K, Pluymaekers, NAHA, Hendriks, JM, Manninger, M, Duncker, D & Linz, D 2022, 'Self-Reported Mobile Health-Based Risk Factor and CHA₂DS₂-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results', Frontiers in Cardiovascular Medicine, vol. 8, 757587. https://doi.org/10.3389/fcvm.2021.757587

TY - JOUR

T1 - Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation

T2 - TeleCheck-AF Results

AU - Hermans, Astrid N.L.

AU - Gawałko, Monika

AU - Hillmann, Henrike A.K.

AU - Sohaib, Afzal

AU - van der Velden, Rachel M.J.

AU - Betz, Konstanze

AU - Verhaert, Dominique

AU - Scherr, Daniel

AU - Meier, Julia

AU - Sultan, Arian

AU - Steven, Daniel

AU - Terentieva, Elena

AU - Pisters, Ron

AU - Hemels, Martin

AU - Voorhout, Leonard

AU - Lodziński, Piotr

AU - Krzowski, Bartosz

AU - Gupta, Dhiraj

AU - Kozhuharov, Nikola

AU - Gruwez, Henri

AU - Vernooy, Kevin

AU - Pluymaekers, Nikki A.H.A.

AU - Hendriks, Jeroen M.

AU - Manninger, Martin

AU - Duncker, David

AU - Linz, Dominik

PY - 2022/1/19

Y1 - 2022/1/19

N2 - Introduction: The TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA2DS2-VASc-score in atrial fibrillation (AF) patients managed within this approach. Materials and Methods: Consecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA2DS2-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR). Results: Among 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%—overtreated. Conclusion: Self-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA2DS2-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.

AB - Introduction: The TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA2DS2-VASc-score in atrial fibrillation (AF) patients managed within this approach. Materials and Methods: Consecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA2DS2-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR). Results: Among 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%—overtreated. Conclusion: Self-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA2DS2-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.

KW - atrial fibrillation

KW - mobile health

KW - photoplethysmography

KW - risk factors

KW - thromboembolic risk

UR - http://www.scopus.com/inward/record.url?scp=85128765599&partnerID=8YFLogxK

U2 - 10.3389/fcvm.2021.757587

DO - 10.3389/fcvm.2021.757587

M3 - Article

AN - SCOPUS:85128765599

SN - 2297-055X

VL - 8

JO - Frontiers in Cardiovascular Medicine

JF - Frontiers in Cardiovascular Medicine

M1 - 757587

ER -