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Presentation
Developing a Community-Based Screening and Referral Mechanism for Atrial Fibrillation in Low Resource Settings: “Smartphone Monitoring for Atrial Fibrillation in Real-Time – India (SMART-India)”
UMass Center for Clinical and Translational Science Research Retreat
  • Apurv Soni, University of Massachusetts Medical School
  • Nisha Fahey, University of Massachusetts Medical School
  • Harshil Patel, Pramukhswami Medical College
  • Kandarp Talati, Pramukhswami Medical College
  • Anna Handorf, University of Massachusetts Medical School
  • John A. Bostrom, University of Massachusetts Medical School
  • Shyamsundar Raihatha, Pramukhswami Medical College
  • Ravi Shah, University of Massachusetts Medical School
  • Sunil Karna, Pramukhswami Medical College
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Ki Chon, University of Connecticut - Storrs
  • Somashekhar M. Nimbalkar, Pramukhswami Medical College
  • David D. McManus, University of Massachusetts Medical School
Start Date
16-5-2017 1:45 PM
Document Type
Poster Abstract
Description

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for community-based AF screening.

METHODS: We built on findings from our feasibility study and leveraged two novel technologies as well as an existing community health program to screen 2,500 people from 60 villages of Anand District. A single-lead EKG and a pulse-based app was used to screen each individual for AF 3 times over a period of 5 days. Participants with suspected arrhythmias were referred at a local tertiary-care hospital for further evaluation and follow up with a cardiologist. Participants diagnosed with AF were initiated on treatment as deemed appropriate by the cardiologist.

ANALYTICAL PLAN: Age- and sex-stratified AF prevalence for AF will be calculated using survey weights to estimate population prevalence. Sociodemographic and clinical factors associated with AF will be evaluated using multivariable regression methods. Performance of each mobile technology in detecting AF will be evaluated by measuring sensitivity, specificity, and discriminative ability while considering a 12-lead EKG interpretation as gold-standard.

CONCLUSIONS: Effective approaches for leveraging state-of-the-art technology to develop a screening and referral mechanism for AF in low-resource settings requires active participation with community partners and health workers.

Keywords
  • atrial fibrillation,
  • cardiovascular diseases,
  • arrhythmia
Creative Commons License
Creative Commons Attribution-Noncommercial-Share Alike 3.0
Citation Information
Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, et al.. "Developing a Community-Based Screening and Referral Mechanism for Atrial Fibrillation in Low Resource Settings: “Smartphone Monitoring for Atrial Fibrillation in Real-Time – India (SMART-India)”" (2017)
Available at: http://works.bepress.com/robert_goldberg/467/