MyDiagnostick tool accurately detects AF in multi-ethnic Asians

A simple device for atrial fibrillation (AF) screening, MyDiagnostick, demonstrates high sensitivity and specificity when used in Asians, reports a study in Singapore. Moreover, it can be reliably used by nonspecialist professionals in the community setting.

In this study, researchers compared MyDiagnostick with manual pulse check for AF screening in a cohort of 671 individuals from a multi-ethnic Asian population.

AF prevalence stood at 1.78 percent. Among the 12 individuals found to have AF, six (50.0 percent) had a history of AF and the remaining six (50.0 percent) were newly diagnosed. Those with AF during the screening were older (72.0 vs 56.0 years; p<0.0001) and had a higher CHADSVASC risk score (2.9 vs 1.5; p=0.0001). [Singapore Med J 2023;64:430-433]

The 1.78-percent AF prevalence in this Asian cohort is similar to that reported in an overseas predominant Caucasian population. [Stroke 2013;44:3103-3108; J Am Heart Assoc 2015;4:e001486].

On the other hand, AF screening among Chinese in Hong Kong revealed a 2.3-percent prevalence (95 percent confidence interval [CI], 2‒2.6), while the most recent study done among Singapore Chinese revealed a similar rate of 1.5 percent. [J Electrocardiol 2008;41:94-98]

Notably, the sensitivity and the specificity of MyDiagnostick were 100.0 percent and 96.2 percent, respectively, while those of manual pulse check were 83.3 percent and 98.9 percent, respectively.

“Its sensitivity and specificity are comparable and validated across various studies performed in different cohorts of population,” the researchers said. “AF prevalence in this low-risk Asian cohort is similar to that seen in other countries.”

In an earlier study, MyDiagnostick had a sensitivity of 94 percent (95 percent CI, 87‒98) and specificity of 93 percent (95 percent CI, 85‒97) in a primary care setting with most patients known to have AF. [BMC Fam Pract 2014;15:113]

When used in another primary care cohort of patients with a lower AF prevalence, the tool demonstrated a sensitivity of 95 percent (95 percent CI, 93‒100) and specificity of 95.9 percent (95 percent CI, 91.3‒98.1). [Europace 2014;16:1291-1295]

Though reliable, MyDiagnostic is a less cost-effective tool when compared with manual pulse check, according to the researchers. However, the latter can only be available in the general community after training patients or screeners to differentiate between a regular and an irregular pulse.

In the current study, nurses performed the manual pulse check, while nonmedical personnel administered the MyDiagnostick.

The current study was limited by a possible biased population and single-centre design, so the sample cohort could not be considered as representative of the general population. In addition, the medical histories of the participants might not be accurate, since they were offered voluntarily and did not undergo verification.

“AF is the most common arrhythmia, occurring in 1 percent to 2 percent of the general population, and its prevalence increases with age. [It also] increases the risk of stroke by up to five times,” the researchers said. [Eur Heart J 2012;33:2719-2747]

“Although anticoagulation is an effective therapy for reducing the risk of stroke, documentation of AF on electrocardiography is required before initiation of therapy,” they added.