Pooled yield of screening was greater in males across all age strata .
Neither the choice of screening methodology or device , the geographical region , nor the screening setting influenced the detection rate of AF .
The main limitation of this study is there are insufficient data on sociodemographic variables of the population s and possible ascertainment biases to explain the variance in the sample s. CONCLUSIONS People with screen-detected AF are at elevated calculated stroke risk : above age 65 , the majority have a Class-1 OAC recommendation for stroke prevention , and > 70 % have ≥1 additional stroke risk factor other than age/sex .
BACKGROUND The precise age distribution and calculated stroke risk of screen-detected atrial fibrillation ( AF ) is not known .
Therefore , it is not possible to determine the number needed to screen ( NNS ) to identify one treatable new AF case ( NNS-Rx ) ( i.e. , Class-1 oral anticoagulation [ OAC ] treatment recommendation ) in each age stratum .
If the NNS-Rx is known for each age stratum , precise cost-effectiveness and sensitivity simulations can be performed based on the age distribution of the population /region to be screened .
Such calculations are required by national authorities and organisations responsible for health system budgets to determine the best age cutoffs for screening programs and decide whether programs of screening should be funded .
Therefore , we aim ed to determine the exact yield and calculated stroke-risk profile of screen-detected AF and NNS-Rx in 5-year age strata .
Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial.
OBJECTIVE The goal of this study was to assess the effectiveness of opportunistic screening through pulse palpation in the early detection of  atrial fibrillation in subjects aged≥65 years versus detection through an active search for patients with symptoms and /or complications and sequelae associated . MATERIAL AND METHODS This was a cluster r and omized controlled trial performed in 48 primary care centers of the Spanish National Healthcare System . A total of 368 physicians and nurses were r and omized . The research ers in the experimental group ( EG ) performed opportunistic screening for auricular fibrillation , whereas the research ers in the control group ( CG ) actively search ed for symptomatic patients . An  ECG  was performed on patients found to have an irregular heartbeat to confirm the diagnosis of auricular fibrillation . RESULTS A total of 5,465 patients with a mean age of 75.61 years were recruited for the EG , and 1,525 patients with a mean age of 74.07 years were recruited for the CG . Of these , 58.6 % were female , without significant differences between groups . Pulse was irregular in 4.3 and 15.0 % of the patients in the EG and the CG , respectively ( P<.001 ) . A total of 164 new cases of atrial fibrillation were detected ( 2.3 % ) , 1.1 % in the EG and 6.7 % in the CG ( adjusted OR : 0.29 ; 95 % CI 0.18 - 0.45 ) . CONCLUSIONS Case finding for atrial fibrillation in patients aged≥65 years with symptoms or signs suggestive of atrial fibrillation is a more effective strategy than opportunistic screening through pulse palpation in asymptomatic patients . TRIAL REGISTRATION The trial is registered in Clinical Trials.gov ( NCT01291953 ; February 8 , 2011 )
Pooled yield of screening was greater in males across all age strata .
Neither the choice of screening methodology or device , the geographical region , nor the screening setting influenced the detection rate of AF .
The main limitation of this study is there are insufficient data on sociodemographic variables of the population s and possible ascertainment biases to explain the variance in the sample s. CONCLUSIONS People with screen-detected AF are at elevated calculated stroke risk : above age 65 , the majority have a Class-1 OAC recommendation for stroke prevention , and > 70 % have ≥1 additional stroke risk factor other than age/sex .
BACKGROUND The precise age distribution and calculated stroke risk of screen-detected atrial fibrillation ( AF ) is not known .
Therefore , it is not possible to determine the number needed to screen ( NNS ) to identify one treatable new AF case ( NNS-Rx ) ( i.e. , Class-1 oral anticoagulation [ OAC ] treatment recommendation ) in each age stratum .
If the NNS-Rx is known for each age stratum , precise cost-effectiveness and sensitivity simulations can be performed based on the age distribution of the population /region to be screened .
Such calculations are required by national authorities and organisations responsible for health system budgets to determine the best age cutoffs for screening programs and decide whether programs of screening should be funded .
Therefore , we aim ed to determine the exact yield and calculated stroke-risk profile of screen-detected AF and NNS-Rx in 5-year age strata .