Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
Although these approaches have comparable effects on the overall AF diagnosis rate , the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) , the most common arrhythmia in clinical practice , is a leading cause of morbidity and mortality .
Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy before the onset of symptoms .
However , for screening to be an effective intervention , it must improve the detection of AF and provide benefit for those detected earlier as a result of screening .
OBJECTIVES This review aims to answer the following questions .Does systematic screening increase the detection of AF compared with routine practice ?
Which combination of screening population , strategy and test is most effective for detecting AF compared with routine practice ?
What safety issues and adverse events may be associated with individual screening programmes ?
How acceptable is the intervention to the target population ?
What costs are associated with systematic screening for AF ?
Multifaceted implementation of stroke prevention guidelines in primary care: cluster-randomised evaluation of clinical and cost effectiveness
Objective : To evaluate clinical and cost effectiveness of implementing evidence -based guidelines for the prevention of stroke . Design : Cluster-r and omised trial Setting : Three primary care organisations in the North of Engl and covering a population of 400 000 . Participants : Seventy six primary care teams in four clusters : North , South & West , City I and City II . Intervention : Guidelines for the management of patients with atrial fibrillation and transient ischaemic attack ( TIA )  were developed and implemented using a multifaceted approach including evidence -based recommendations , audit and feedback , interactive educational sessions , patient prompts and outreach visits . Outcomes : Identification and appropriate treatment of patients with atrial fibrillation or TIA , and cost effectiveness . Results : Implementation led to 36 % increase ( 95 % CI 4 % to 78 % ) in diagnosis of atrial fibrillation , and improved treatment of TIA ( odds ratio of complying with guidelines 1.8 ; 95 % CI 1.1 to 2.8 ) . Combined analysis of atrial fibrillation and TIA estimates that compliance was significantly greater ( OR 1.46 95 % CI 1.10 to 1.94 ) in the condition for which practice s had received the implementation programme . The development and implementation of guidelines cost less than £ 1500 per practice . The estimated costs per quality -adjusted life year gained by patients with atrial fibrillation or TIA were both less than £ 2000 , very much less than the usual criterion for cost effectiveness . Conclusions : Implementation of evidence -based guidelines  improved the quality of primary care for atrial fibrillation and TIA . The intervention was feasible and very cost effective . Key components of the model include context ual analysis , strong professional support , clear recommendations based on robust evidence , simplicity of adoption , good communication and use of established networks and opinion leaders
Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
Although these approaches have comparable effects on the overall AF diagnosis rate , the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) , the most common arrhythmia in clinical practice , is a leading cause of morbidity and mortality .
Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy before the onset of symptoms .
However , for screening to be an effective intervention , it must improve the detection of AF and provide benefit for those detected earlier as a result of screening .
OBJECTIVES This review aims to answer the following questions .Does systematic screening increase the detection of AF compared with routine practice ?
Which combination of screening population , strategy and test is most effective for detecting AF compared with routine practice ?
What safety issues and adverse events may be associated with individual screening programmes ?
How acceptable is the intervention to the target population ?
What costs are associated with systematic screening for AF ?