Atrial fibrillation (AF) is a condition in which an individual has an irregular heart-beat. This can lead to blood pooling in the heart and as a result people who have AF are more likely to have a stroke.
Many individuals with AF are unaware that they have the condition and often only become aware of the condition upon occurrence of a stroke. Population-wide screening programs would allow for the timely identification and treatment of such individuals however a lack of evidence regarding the cost-effectiveness of such programs means such a program has not been implemented in the UK.
Targeting screening to subgroups of the population in which AF is particularly common would improve cost-effectiveness. In this study we explore whether routine consultations or clinics typically attended by individuals with a high prevalence of AF risk factors could be utilised for screening.
We will use a large patient database to investigate whether consultations for certain types of events, including influenza vaccination, heart problems and diabetes, are commonly recorded prior to an AF diagnosis. We will explore whether these consultations are more commonly recorded prior to an AF diagnosis than in a group of similar individuals without diagnosis.
Objectives
To investigate whether the prevalence of certain consultations are increased in the 3-year period prior to an AF diagnosis relative to the prevalence in a matched AF-free control group.
Methods
The study will use a matched case control design in which a group of individuals with AF will be identified and matched to a set of controls without AF based on age, sex and practice. The prevalence of consultations for influenza vaccinations, congestive heart failure, coronary artery disease, peripheral artery disease and diabetes in the 3 year period prior to the index date will be described for cases and for controls and conditional logistic regression will be used to estimate odds ratios and 95% confidence intervals describing the relationship between the prevalence in cases and controls. Subgroup analyses will stratify the AF cases into early and late diagnoses (based on whether a thromboembolic event led to the identification of AF).
As an exploratory analysis an additional set of consultation types will be identified based on their prevalence in the cases and a selection of the analysis will be repeated for a selection of the identified consultations.
Influenza vaccination
Congestive heart failure
Coronary artery disease
Peripheral artery disease
Diabetes
Sreeram Ramagopalan - Chief Investigator - London School Of Economics & Political Science
Cormac Sammon - Corresponding Applicant - PHMR Associates Limited ( UK )
Elaine Stamp - Collaborator - PHMR Associates Limited ( UK )
Megan Besford - Collaborator - PHMR Associates Limited ( UK )
Tzu-Chun Kuo - Collaborator - PHMR Associates Limited ( UK )
HES Admitted Patient Care