P159 Monitoring prolongation of QT interval in patients with multidrug-resistant tuberculosis and non-tuberculous mycobacterium using mobile health device AliveCor

Puranik, Shriya; Harlow, Christopher; Park, M; Martin, L; Coleman, Mira A.; Russell, Georgina; Kon, OM

doi:10.1136/thorax-2020-btsabstracts.304

Cited by 2 publications

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“…15 Chapter 4 Systematic review results t he literature searches of bibliographic databases conducted for this EVA systematic review, including additional scoping searches conducted to identify costs and cost-effectiveness studies, identified 8505 unique references. After initial screening of titles and abstracts, 28 references were considered to be potentially relevant and ordered for full paper screening; of these 10 publications, 26,31,34,37,[39][40][41][42][43] relating to six studies, were included in the review. A further three publications, one provided by NICE/ Specialist Committee Members (SCMs) 14 and two provided by the manufacturer of KardiaMobile 6L, AliveCor, 51,52 were assessed and included in the review.…”

Section: Methods Of Analysis/synthesismentioning

confidence: 99%

“…Based on the searches and inclusion screening described above, 13 publications, 14,26,31,34,37,[39][40][41][42][43]51,52 relating to 8 studies, and 2 additional unpublished reports, 53,54 were included in this review; the results section of this report cites studies using the primary publication only.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…For attribution the title, original author(s), the publication source -NIHR Journals Library, and the DOI of the publication must be cited. 43 Neurodivergent people (e.g. those with autism spectrum disorder) may be more likely to have antipsychotic medication than the general population.…”

Section: Reporting Equality Diversity and Inclusionmentioning

confidence: 99%

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KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

Westwood,

Armstrong,

Posadzki

et al. 2024

Health Technol Assess

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Background The indication for this assessment is the use of the KardiaMobile six-lead electrocardiogram device for the assessment of QT interval-based cardiac risk in service users prior to the initiation of, or for the monitoring of, antipsychotic medications, which are associated with an established risk of QT interval prolongation. Objectives To provide an early value assessment of whether KardiaMobile six-lead has the potential to provide an effective and safe alternative to 12-lead electrocardiogram for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications. Review methods Twenty-seven databases were searched to April/May 2022. Review methods followed published guidelines. Where appropriate, study quality was assessed using appropriate risk of bias tools. Results were summarised by research question; accuracy/technical performance; clinical effects (on cardiac and psychiatric outcomes); service user acceptability/satisfaction; costs of KardiaMobile six-lead. Results We did not identify any studies which provided information about the diagnostic accuracy of KardiaMobile six-lead, for the detection of corrected QT-interval prolongation, in any population. All studies which reported information about agreement between QT interval measurements (corrected and/or uncorrected) with KardiaMobile six-lead versus 12-lead electrocardiogram were conducted in non-psychiatric populations, used cardiologists and/or multiple readers to interpret electrocardiograms. Where reported or calculable, the mean difference in corrected QT interval between devices (12-lead electrocardiogram vs. KardiaMobile six-lead) was generally small (≤ 10 ms) and corrected QT interval measured using KardiaMobile six-lead was consistently lower than that measured using 12-lead electrocardiogram. All information about the use of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication, was taken from retrospective surveys of staff and service users who had chosen to use KardiaMobile six-lead during pilots, described in two unpublished project reports. It is important to note that both these project reports relate to pilot studies which were not intended to be used in wider evaluations of KardiaMobile six-lead for use in the NHS. Both reports included survey results which indicated that the use of KardiaMobile six-lead may be associated with reductions in the time taken to complete an electrocardiogram and costs, relative to 12-lead electrocardiogram, and that KardiaMobile six-lead was preferred over 12-lead electrocardiogram by almost all responding staff and service users. Limitations There was a lack of published evidence about the efficacy of KardiaMobile six-lead for initial assessment and monitoring of QT interval-based cardiac risk in people taking antipsychotic medications. Conclusions There is insufficient evidence to support a full diagnostic assessment evaluating the clinical and cost effectiveness of KardiaMobile six-lead, in the context of QT interval-based cardiac risk assessment for service users who require antipsychotic medication. The evidence to inform the aims of this early value assessment (i.e. to assess whether the device has the potential to be clinically effective and cost-effective) was also limited. This report includes a comprehensive list of research recommendations, both to reduce the uncertainty around this early value assessment and to provide the additional data needed to inform a full diagnostic assessment, including cost-effectiveness modelling. Study registration This study is registered as PROSPERO CRD42022336695. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135520) and is published in full in Health Technology Assessment; Vol. 28, No. 19. See the NIHR Funding and Awards website for further award information.

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Section: Methods Of Analysis/synthesismentioning

confidence: 99%

Section: Overview Of Included Studiesmentioning

confidence: 99%

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KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

Westwood,

Armstrong,

Posadzki

et al. 2024

Health Technol Assess

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“…Relatively few studies have investigated the six-lead device version. One small study showed the six-lead ACKM device underestimated QTc in twelve of thirteen patients with multidrug-resistant tuberculosis by a mean difference of 3% [11]. Pilot data has also shown good agreement of QTc, PR, and QRS intervals between the six-lead device and a standard twelve-lead ECG in young healthy athletes [12], however, there is no information on the accuracy of the device in a pediatric population…”

Section: Introductionmentioning

confidence: 99%

Comparison of AliveCor KardiaMobile Six-Lead ECG with Standard ECG in Pediatric Patients

2022

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Background: The AliveCor KardiaMobile (ACKM) is a remote electrocardiogram (ECG) monitoring device.Little research has been conducted on its accuracy with pediatric patients. This prospective study aims to compare the ACKM six-lead device with a standard fteen-lead ECG in measuring the QTc, QRS, and axis in pediatric patients.Methods: Pediatric patients ages 5 to 21 years were enrolled prospectively to have their ECG recorded using an ACKM six-lead device following a recording with the standard fteen-lead ECG. A pediatric electrophysiologist measured the QTc, QRS interval, and QRS axis for both ECGs. Bland-Altman analysis was performed to assess agreement among measurements.Results: The study included 141 patients. The mean age was 12.3 ± 4.4 years. Average heart rate was 79 ± 16 bpm. The mean difference in the QTc measurements for a paired standard ECG and ACKM was -0.6 ms [95% con dence interval -48 to 47 ms]. Of the ACKM QTc measurements, 117 (83%) were within 30 ms of the standard ECG. The mean difference in paired QRS measurements was -1.3 ms [95% con dence interval -23 to 21 ms]. Of the ACKM QRS measurements, 134 (95%) were within 20 ms of the standard ECG. The measured axis was the same for 84% of ACKM and standard ECGs.Conclusions: Over 80% of the ACKM six-lead ECGs produced QTc, QRS, and axis deviation measurements within a clinically useful range of the standard ECG. However, it is not accurate enough to be used consistently in place of a standard ECG for QTc and QRS measurement for pediatric patients.

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P159 Monitoring prolongation of QT interval in patients with multidrug-resistant tuberculosis and non-tuberculous mycobacterium using mobile health device AliveCor

Cited by 2 publications

References 0 publications

KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

KardiaMobile 6L for measuring QT interval in people having antipsychotic medication to inform early value assessment: a systematic review

Comparison of AliveCor KardiaMobile Six-Lead ECG with Standard ECG in Pediatric Patients

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