Predictive validity of automated oscillometric blood pressure monitors for screening atrial fibrillation: a systematic review and meta-analysis

ABSTRACT

Background: This study was conducted to verify if automated oscillometric blood pressure monitors (AOBPMs) have sufficiently high predictive validity to screen patients with atrial fibrillation (AF).

Methods: Electronic searches were performed to identify all studies published between 1946 and 14 July 2018, from indexed in Ovid-Medline, Embase, the Cochrane Library, and CINAHL by using the following keywords: ‘atrial fibrillation,’ ‘atrial flutter,’ ‘blood pressure monitor,’ and ‘sphygmomanometer.’

Results: Thirteen diagnostic accuracy studies, including a total of 9,380 elderly, were included in our meta-analysis. The meta-analysis showed that the pooled sensitivity was 0.91 (95% CI, 0.89 to 0.93), and the heterogeneity between studies was as high as 88.4% (X² = 120.55, p < 0.001). The pooled specificity was 0.96 (95% CI, 0.96 to 0.97), and the heterogeneity between studies was 95.3% (X² = 299.26, p < .001). The area under the curve (AUC) of the summary receiver operating characteristic (sROC) curve was 0.98 (SE = 0.005), and the Q-value was 0.94 (SE = 0.010).

Conclusion: The AOBPM is an appropriate screening tool that may be applied to elderly to verify the presence of AF conveniently. The AOBPM has high applicability in practice, since it may prevent potentially fatal complications such as stroke.

KEYWORDS:

• Atrial fibrillation
• blood pressure determination
• meta-analysis
• sensitivity and specificity
• sphygmomanometers

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

One peer reviewer has received consultancy fees and investigational grants from Microlife and lecture fees from Omron. Another peer reviewer has declared financial relationships with MDT, BosSci, SJM, Biotronik, Livanova, Gilead, Biosense, Cardiofocus, Vytronus, ARCA-Biopharma, Iowa approach. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This work was supported by the Soonchunhyang University Research Fund.