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Similar heart rates between atrial fibrillation and sinus rhythm in asymptomatic populations justify large scale screening to improve the detection of atrial fibrillation.
No full textPurpose: Atrial fibrillation (AF) is known to be asymptomatic in up to 1/3 of patients. Early detection is however useful to prevent thrombo-embolic event. Since 2010, large awareness and screening campaigns are organized annually on a national level. Clinical characteristics of AF diagnosed during screening in this asymptomatic population are however not known.
Methods: Voluntary screening was performed using the Omron® Heart Scan. At the moment of screening, subjects were asked to complete a simple questionnaire to assess their clinical characteristics. In 2012, 21.586 asymptomatic subjects were screened in 89 hospitals. A total of 17.563 questionnaires was collected from subjects older than 40 years and analyzed using a SPSS program.
Results: At the time of screening, 17.329 subjects were in sinus rhythm (SR) at Heart Scan (group 1), and 234 were in AF (group 2), giving a prevalence of AF of 1.35%. AF was further confirmed by a 12 lead ECG performed immediately after the screening in 56 subjects (group 3). Mean heart rate at the time of screening in group 1, 2 and 3 was 80 ± 14, 86 ± 20, and 92 ± 23 bpm. Mean age was 61 ± 11, 70 ± 10, and 69 ± 11 years. CHA2DS2VASc score was 1.6 ± 1.2, 2.5 ± 1.5, and 2.5 ± 1.5 respectively.
Conclusions: A large overlap of heart rates between subjects in AF or in SR was observed in this asymptomatic population. A heart rate < 110 bpm was noted in the majority of subjects in AF, which might explain the asymptomatic nature of AF in this population. These findings highlight the necessity of screening for asymptomatic AF in patients at risk for thrombo-embolic events
Screening for atrial fibrillation in the general population: the optimal age limit. Results from the Belgian heart rhythm week 2010-2012
No full textDiagnosing AF in patients aged 65 years (y) or over, before the first embolic complication, is recognized as a class I recommendation by the recent ESC guidelines. However, data are lacking in the general population to select the critical lower age limit to organize large screening programs. Since 2010, Belgian citizens preferably over 40 y old were invited by the media during an annual “Heart Rhythm Week” to participate in a free screening in 89 hospitals. Participants were invited to fill in a validated stroke risk stratification questionnaire registering CHA2DS2-VASc- score, and a one lead ECG with a hand held monitor was performed. Over 3 y, 55.359 voluntary subjects were screened representing 0.5% of the national population, 59%
were women and mean age was 57 ± 14 y. AF was detected in 840 patients (1.52%), 49% were women and mean age was 67 ± 13 y (p65 y, AF was present in 437 (3.03%). Prevalence of AF varied from 0.5% in subjects < 40y to 0.7% in 40-44y, 0.7% in 45-49y, 0.8% in 50-54y, 1.1% in 55-59y,
1.1% in 60-64y, 1.7% in 65-69y, 2.8% in 70-74y, 4.0% in 75-79y, 5.6% in 80-84y, and 6.1% in >85y. In subjects aged 40-64y, CHA2DS2-VASc score was 0.5 ± 1 in subjects in sinus rhythm and 0.7 ± 1.1 in AF patients. In subjects aged >65y, CHA2DS2-VASc score was 2.8 ± 1.5 in subjects in sinus rhythm and 3.2 ± 1.7 in AF patients. AF was detected in 1 patient for every 24 test in subjects > 70 y, 56 test in 69-65y, 86 tests in 64-60y, 90 tests in 59-55y, 122 tests in 54-50y, 140 tests in 49-45y, 139 tests in
44-40y. We conclude that limiting a large screening population only to subjects >65y would have missed AF diagnosis in a significant number of patients. However the costs associated with these large scale screenings have to be balanced against the benefit of early detection of AF in younger patients with lower CHA2DS2-VASc scores
Screening for atrial fibrillation in the general population: the optimal age limit. Results from the Belgian heart rhythm week 2010-2012
No full textDiagnosing AF in patients aged 65 years (y) or over, before the first embolic complication, is recognized as a class I recommendation by the recent ESC guidelines. However, data are lacking in the general population to select the critical lower age limit to organize large screening programs. Since 2010, Belgian citizens preferably over 40 y old were invited by the media during an annual “Heart Rhythm Week” to participate in a free screening in 89 hospitals. Participants were invited to fill in a validated stroke risk stratification questionnaire registering CHA2DS2-VASc- score, and a one lead ECG with a hand held monitor was performed. Over 3 y, 55.359 voluntary subjects were screened representing 0.5% of the national population, 59%
were women and mean age was 57 ± 14 y. AF was detected in 840 patients (1.52%), 49% were women and mean age was 67 ± 13 y (p65 y, AF was present in 437 (3.03%). Prevalence of AF varied from 0.5% in subjects < 40y to 0.7% in 40-44y, 0.7% in 45-49y, 0.8% in 50-54y, 1.1% in 55-59y,
1.1% in 60-64y, 1.7% in 65-69y, 2.8% in 70-74y, 4.0% in 75-79y, 5.6% in 80-84y, and 6.1% in >85y. In subjects aged 40-64y, CHA2DS2-VASc score was 0.5 ± 1 in subjects in sinus rhythm and 0.7 ± 1.1 in AF patients. In subjects aged >65y, CHA2DS2-VASc score was 2.8 ± 1.5 in subjects in sinus rhythm and 3.2 ± 1.7 in AF patients. AF was detected in 1 patient for every 24 test in subjects > 70 y, 56 test in 69-65y, 86 tests in 64-60y, 90 tests in 59-55y, 122 tests in 54-50y, 140 tests in 49-45y, 139 tests in
44-40y. We conclude that limiting a large screening population only to subjects >65y would have missed AF diagnosis in a significant number of patients. However the costs associated with these large scale screenings have to be balanced against the benefit of early detection of AF in younger patients with lower CHA2DS2-VASc scores
Prevalence of atrial fibrillation in adults participating in a large-scale voluntary screening programme in Belgium
No full textObjective Atrial fibrillation (AF) is a common arrhythmia in clinical practice. AF fulfils many of the criteria for a screening programme. No data about the prevalence of AF in non-hospitalized patients are available in Belgium. The aim of the study was to assess feasibility and effectiveness of a nationwide-organized voluntary screening programme in the general population in Belgium. Methods A total of 13.564 participants were screened, of whom 10,758 were older than 40 years (GSP group). Participants filled in stroke risk stratification questionnaires (CHADS2 and CHA2DS2-VASc). A one-lead electrocardiogram was performed. Results 228 participants had AF at the time of screening (AF group), with 125 women and 103 men (i.e. 1.9% and 2.6% of total women and men), representing a prevalence of 2.2% (95% Cl 1.3% and 3.0%) of the screened population. Age of the AF group was 67 +/- 12 y (range 40-87 y). Using the CHADS2-score, 58% of participants with a positive AF screening had a high risk score, and 21% had an intermediate risk score. Using the CHA2DS2-VASc-score, 72% of the participants had a high risk score, and 21% had an intermediate risk score. Conclusion AF was present in 2.2% of the respondents. At least 60% of AF group had an increased risk for thrombo-embolism. Although substantial methodological issues limit the exact interpretation of these results, the present study shows that a volunatry screening programme with a simple screening protocol is able to detect an important number of patients with previously undetected AF
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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