May 17, 2021
National Center for Health Research’s Public Comments on the United States Preventive Services Task Force’s Draft Recommendation Regarding Screenings for Atrial Fibrillation in Asymptomatic Adults
We are writing to express our views on the U.S. Preventive Services Task Force’s (USPSTF) draft recommendation statement regarding the screening for atrial fibrillation in asymptomatic adults ages 50 and over.
The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
We support the “I” rating that there is insufficient evidence to assess the benefits and harms of screening for atrial fibrillation in asymptomatic adults ages 50 and over. Not only is there inadequate evidence to assess the benefits of one-time screening strategies, there are potential risks to treatment. Anticoagulant therapy interventions are known to carry a small to moderate risk of harm, risks, particularly an increased risk of bleeding.1 In summary, there are unknown benefits of screening while there are known risks.
We also support the need for future research, as highlighted by USPSTF, in order to fully assess the potential benefits and harms of screening. Further, since none of the studies reviewed reported information about the race or ethnicity of patients, USPSTF should note this lack of information about patient demographics and diverse sample populations when identifying research gaps. The inclusion of diverse samples in future research will allow for subgroup analyses that assess whether the benefits and harms vary between patient populations.
References
- Ballatore A, Matta M, Saglietto A, Desalvo P, Bocchino PP, Gaita F, De Ferrari GM, Anselmino M. Subclinical and asymptomatic atrial fibrillation: current evidence and unsolved questions in clinical practice. Medicina. 2019; 55(8):497.