Summary of PPG interpretation capability by HCPs

In two studies from Vandenberk et al. paired PPG and single-lead ECG recordings were reviewed by two independent cardiologists. In the first study, interpretation of PPG recordings by both cardiologists resulted in an averaged sensitivity and specificity of 96% and 99%, respectively. The results were confirmed in a second study, where two cardiologists, unfamiliar with PPG signals, yielded an average sensitivity of 96% and a specificity of 100%. 

Gruwez et al. (2021) compared the accuracy of PPG and ECG interpretation to detect or rule out AF by cardiologists and electrophysiologists with and without experience. Results demonstrated that physicians can detect AF based on a PPG output with an equivalent sensitivity (96%, P=0.67) and specificity (93%, P=0.54) compared to single-lead ECG. However, to yield this performance, a RR tachogram and poincaré plot should be provided to facilitate the interpretation of the PPG waveforms. Results were consistent in physicians with and without prior PPG experience. These findings suggest that algorithm assessment, combined with manual overreading by HCPs may optimize the performance and reduce workload.

Van Der Velden et al. (2021) introduced a newly developed, stepwise practical guide on PPG signal interpretation based on experiences from the TeleCheck-AF program. The present clinical scenarios and stepwise approach for the use of on-demand PPG technology support HCPs to implement PPG technology in their daily routine. 

Information retrieved from the following peer-reviewed publications

• PPG versus single lead ECG for the diagnosis of Atrial Fibrillation - Vandenberk et al, 2017

• Atrial Fibrillation Diagnosis Based on a Smartphone Derived PPG Waveform-A Diagnostic Accuracy Study versus Single-Lead - Vandenberk et al, 2018

• Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF - Gruwez et al, 2021

• The photoplethysmography dictionary-practical guidance on signal interpretation and clinical scenarios from TeleCheck-AF - Van Der Velden et al, 2021