Jonas publishes two JAMA Evidence Reports on ECG Cardiac Screenings

Dan Jonas, MD, MPH, associate professor of medicine and deputy director for research at the Cecil G. Sheps Center for Health Services Research, found that using electrocardiography in screening asymptomatic adults for cardiovascular disease may cause more harm than good.

Jonas publishes two JAMA Evidence Reports on ECG Cardiac Screenings click to enlarge Dan Jonas, MD, MPH
Jonas publishes two JAMA Evidence Reports on ECG Cardiac Screenings click to enlarge Gary Asher, MD, MPH

August 7, 2018

Media Contact: Jamie Williams, jamie.williams@unchealth.unc.edu, 984-974-1149

In a paper published in JAMA earlier this summer, Jonas and Gary Asher, MD, MPH, of the Department of Family Medicine, evaluated the effectiveness of screening asymptomatic adults for cardiovascular disease risk with resting or exercise electrocardiography (ECG), a test that measures electrical changes in your heart. Despite a focus on high-risk populations with diabetes, clinical trials found no improvement in health outcomes. In some cases, the screenings actually led to harm to the patient in the form of additional unnecessary tests, arrhythmias, cardiovascular events, injuries, anxiety, labeling and other issues.

“Screening for cardiovascular disease risk with ECG in asymptomatic, low-risk adults is likely more harmful than beneficial,” Jonas said.

The US Preventative Services Task Force used Jonas and Asher’s evidence report to update its recommendations on screening for cardiovascular disease risk, recommending against screening low-risk adults with ECG.

Today, Jonas and collaborators from the RTI-UNC Evidence Based Practice Center published a second JAMA Evidence Report, this time on the effectiveness of using ECG to screen asymptomatic adults for atrial fibrillation.

Their analysis found that screening with ECG can detect more new cases of atrial fibrillation than no screening, but ECG screening has not been shown to be more effective than screening focused on using pulse palpitation to detect atrial fibrillation in older adults.

“The take home message from this paper is that we need more research to determine whether health outcomes are improved by screening for atrial fibrillation with ECG in asymptomatic, older adults,” Jonas said.

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