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| Title | Year | Objective | Key message(s) |
|---|---|---|---|
| Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF | 2021 | To compare the performance of physicians to detect atrial fibrillation (AF) based on photoplethysmography (PPG), single-lead ECG and 12-lead ECG, and to explore the incremental value of PPG presentation as a RR tachogram and poincaré plot, and of algorithm classification for interpretation by physicians. | Physicians can detect AF on a PPG output with equivalent accuracy compared to single-lead ECG in high-quality recordings. A RR tachogram and poincaré plot should be provided to facilitate the interpretation of the PPG waveform. The accuracy did not further improve, when the physicians were provided with the FibriCheck algorithm results in addition to the PPG waveform with plots. It remains that 12-lead ECG is more specific, and thus results in a higher positive predictive value and fewer false positives. |
| Interpretation of photoplethysmography: a step-by-step guide | 2021 | - | - |
| The accuracy of physician interpretation of PPG vs single-lead ECG vs 12-lead ECG for the detection of atrial fibrillation | 2021 | To study the performance of physicians to detect AF based on PPG vs single-lead ECG vs 12-lead ECG, and to explore the incremental value of a RR tachogram, poincaré plot, and algorithm output to the interpretation of the PPG waveform by physicians | Qualitative analysis of a PPG waveform with RR tachogram and poincaré plot had a similar diagnostic performance to detect AF compared to single-lead ECG analysis and a similar sensitivity but lower specificity compared to 12-lead ECG. PPG rhythm recordings, analyzed by physicians as a waveform in combination with the corresponding RR tachogram and poincaré plot, achieve similar diagnostic accuracy as single-lead ECG to detect AF. |
| The photoplethysmography dictionary-practical guidance on signal interpretation and clinical scenarios from TeleCheck-AF | 2021 | To develop an educational structured stepwise practical guide on how to interpret PPG signals and to study typical clinical scenarios how on-demand PPG was used in the TeleCheck-AF project. | Introducing a newly developed structured stepwise practical guide on PPG signal interpretation developed based on presented experiences from TeleCheck-AF. The present clinical scenarios for the use of on-demand PPG technology derived from the TeleCheck-AF project will help to implement PPG technology in the management of arrhythmia patients. |
| The photoplethysmography dictionary-practical guidance on signal interpretation and clinical scenarios from TeleCheck-AF | 2021 | This PPG dictionary aims to provide an overview on PPG technology and describe an educational structured stepwise practical guide on how to analyze and interpret PPG signals recorded within the TeleCheck-AF project. By introducing clinical scenarios where the use of on-demand app-based PPG heart rate and rhythm monitoring can be of clinical benefit and presenting several representative PPG recordings, the task of this manuscript also covers the creation of an educational tool and support to implement PPG technology in clinical practice. | Combining the PPG raw data with the RR tachogram and poincaré plot may improve the readability of PPG recordings. A physician’s own interpretation of the record together with the knowledge of the patient's medical history can improve the diagnosis and even extend it to arrhythmias other than AF. On-demand mHealth combined with teleconsultation is feasible and was received positively by both physicians and patients. Reduced risk of rehospitalization and clinical adverse events was previously demonstrated for an integrated AF care approach supported by mHealth. However, clinical outcomes have not been evaluated in the TeleCheck-AF project, yet. Accelerated through the COVID-19 pandemic and the initiation of the TeleCheck-AF project, more and more centers in Europe have been using PPG technology on-demand around teleconsultations to allow remote heart rate and rhythm assessment of consulted patients. |
| Atrial Fibrillation Diagnosis Based on a Smartphone Derived PPG Waveform-A Diagnostic Accuracy Study versus Single-Lead | 2018 | To determine the ability of AF vs. non-AF diagnosis based on the visual interpretation of a PPG signal vs. a single-lead ECG-signal | The use of a PPG-based smartphone application for AF diagnosis resulted in a relatively high accuracy compared to single-lead ECG, although a significant difference was observed. After data-analysis, solely high-quality became non-significant. This stresses the importance to focus on algorithms that improve the quality or to detect impaired quality issues related to the signal. |
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