USPSTF outlines research plan for examining the use of ECG to screen for CVD risk and atrial fibrillation

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After receiving comments from the public, the U.S. Preventive Services Task Force (USPSTF) recently released its final research plan for screening for cardiovascular disease risk and atrial fibrillation with electrocardiography (ECG).

The researchers will use the plan to assess and publish a systematic review of the evidence that will serve as the USPSTF’s recommendation statement on the topics.

When evaluating the use of ECG to screen for cardiovascular disease risk, the researchers will consider the following three questions:

  • Does adding screening with resting or exercise ECG improve health outcomes in asymptomatic adults compared with traditional cardiovascular disease risk factor assessments?
  • Does adding screening with resting or exercise ECG to traditional risk factor assessments accurately reclassify patients into risk groups or improve the measures of calibration and discrimination?
  • What are the harms of screening with resting or exercise ECG?

When evaluating the use of ECG to screen for atrial fibrillation, the researchers will consider the following five questions:

  • Does screening with ECG improve health outcomes in asymptomatic older adults?
  • Does screening with ECG identify older adults with previously undiagnosed atrial fibrillation more effectively than usual care?
  • What are the harms of screening with ECG in older adults?
  • What are the benefits of anticoagulation or antiplatelet therapy in asymptomatic, screen-detected older adults with atrial fibrillation?
  • What are the harms of anticoagulation or antiplatelet therapy in asymptomatic, screen-detected older adults with atrial fibrillation?

During the comment period, which lasted from May 5 to June 1, the USPSTF received comments suggesting it evaluate some of the questions based on age, sex or race/ethnicity. The organization then added these subgroups. It also replaced the term “cerebral vascular accident” with “stroke,” “cardiometabolic stroke” or “hemorrhagic stroke” when appropriate.

The USPST did not decide to assess other devices for detecting atrial fibrillation and did not add symptoms of atrial fibrillation as an outcome.

The USPSTF includes 16 volunteers who are experts in prevention and evidence-based medicine. They are appointed by the director of the Agency for Healthcare Research and Quality and make an annual report to Congress on the gaps in evidence-based medicine and make recommendations for further examination. However, the USPSTF is independent of the federal government.