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Background: Assessment of patients' knowledge on atrial fibrillation (AF) and its management is important for evaluating their learning needs. However, a validated and comprehensive instrument to be used among Chinese patients is yet to be developed. Objectives: The aim of this study was to develop and validate the Chinese version of the Atrial Fibrillation Knowledge Scale (AFKS-C) in Chinese patients. Methods: The 11-item AFKS was translated, and then content and face validations were conducted by an expert panel and patients with AF. A sample of 255 patients with AF was recruited from a university-affiliated hospital to evaluate its psychometric properties. The internal consistency and test-retest reliability were evaluated using the Kuder-Richardson formula 20 and κ statistics. Item analysis determined the item difficulty index and item discrimination coefficients. Factorial and discriminant validity were evaluated using exploratory factor analysis and the known-groups method. Results: The content validity index of the AFKS-C was 0.94, and the Kuder-Richardson formula 20 value was 0.60. The difficulty indices of the items ranged from 0.36 to 0.89, and the point-biserial coefficients of the items ranged from 0.122 to 0.255, indicating sufficient discriminatory ability. The test-retest reliability was acceptable, because the κ values ranged from 0.234 to 0.710. The principal axis factoring analysis indicated a 3-factor structure that explained 50.4% of the total variance. The AFKS-C also demonstrated satisfactory discriminant validity, having yielded significantly different scores between patients with newly diagnosed and established AF. Conclusion: The AFKS-C has acceptable psychometric properties and can be used to measure the knowledge of patients and evaluate the effects of patient education programs. [ABSTRACT FROM AUTHOR]

Background: The Atrial Fibrillation Effect on Quality-of-Life Questionnaire (AFEQT) is a psychometrically sound instrument for measuring disease-specific health-related quality of life in atrial fibrillation populations. Objective: In this studywe aimed to validate the Chinese version of AFEQT (AFEQT-C) among Chinese patients with atrial fibrillation. Methods: The AFEQT was translated into Chinese according to Brislin's model. The psychometric properties of internal consistency, stability, and concurrent and factorial validity were examined in a convenience sample. Results: A total of 200 participants (mean age, 69.8 ± 5.2 years) were recruited. The Cronbach's α of the AFEQT-C was 0.94, and item-to-total correlations ranged from 0.44 to 0.80. The test-retest reliability was supported by good to excellent intraclass correlation coefficients, which ranged from0.68 to 0.92. The AFEQT-C scores significantly correlatedwith the EuroQoL 5-Dimensional Questionnaire score to support concurrent validity. Confirmatory factor analysis demonstrated a 3-factor structure and all items loaded strongly onto their respective factors. Conclusions: The AFEQT-C is a reliable and valid measure of health-related quality of life in Chinese patients with atrial fibrillation. [ABSTRACT FROM AUTHOR]

The article discusses a study which analyzed patients who underwent carotid artery (CA) stenting with baseline and follow-up carotid duplex ultrasonography and intravascular ultrasound. Results showed that optimal peak systolic velocity (PSV), end-diastolic velocity and internal-to-common CA PSV ratio criteria to detect CA in-stent restenosis were greater compared with those for native CA. It was concluded that the combination of duplex velocity criteria increases diagnostic accuracy.

Supplemental Digital Content is available in the text. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity, defined as the presence of ≥ 2 chronic disorders, has become the norm in many countries as populations age. It remains, however, very infrequently researched. This study evaluated the factors associated with multimorbidity in a predominantly Chinese hypertensive population.Methods: We included all adult patients prescribed their first antihypertensive agents in the public sector of the entire Hong Kong population from a validated clinical database. Multinomial regression analyses were performed to explore factors independently associated with multimorbidity.Results: 223,286 hypertensive patients (average age of 59.9 years, SD 17.6) were included. The prevalence of having 0, 1 and ≥2 additional chronic conditions was 59.6% [133,176/223,286], 32.8% [73,313/223,286] and 7.5% [16,797/223,286], respectively. Older age (>50 years), male sex, lower household income, receipt of comprehensive social security allowance and suboptimal blood pressure control (>140mmHg or >90mmHg; >130mmHg or >80mmHg for diabetes patients; AOR=3.38 to 4.49) were significantly associated with the presence of ≥2 additional conditions. There exists a synergistic effect among these variables as older (≥70 years), male patients receiving security allowance had substantially higher prevalence of ≥2 multimorbidity (19.9% vs 7.5% among all patients).Conclusions: Multimorbidity is very common in hypertensive patients and its prevalence increased markedly with the presence of risk factors identified in this study. Hypertensive patients with multimorbidities should receive more meticulous clinical care as their blood pressure control tends to be poorer. [ABSTRACT FROM AUTHOR]

Background: The Atrial Fibrillation Effect on Quality-of-Life Questionnaire (AFEQT) is a psychometrically sound instrument for measuring disease-specific health-related quality of life in atrial fibrillation populations., Objective: In this study we aimed to validate the Chinese version of AFEQT (AFEQT-C) among Chinese patients with atrial fibrillation., Methods: The AFEQT was translated into Chinese according to Brislin's model. The psychometric properties of internal consistency, stability, and concurrent and factorial validity were examined in a convenience sample., Results: A total of 200 participants (mean age, 69.8 ± 5.2 years) were recruited. The Cronbach's α of the AFEQT-C was 0.94, and item-to-total correlations ranged from 0.44 to 0.80. The test-retest reliability was supported by good to excellent intraclass correlation coefficients, which ranged from 0.68 to 0.92. The AFEQT-C scores significantly correlated with the EuroQoL 5-Dimensional Questionnaire score to support concurrent validity. Confirmatory factor analysis demonstrated a 3-factor structure and all items loaded strongly onto their respective factors., Conclusions: The AFEQT-C is a reliable and valid measure of health-related quality of life in Chinese patients with atrial fibrillation., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document. In August 2016, 51 members met in Rome to discuss the draft document and consider the key points arising from it using a Delphi process. These key points emphasize that screen-detected AF found at a single timepoint or by intermittent ECG recordings over 2 weeks is not a benign condition and, with additional stroke factors, carries sufficient risk of stroke to justify consideration of anticoagulation. With regard to the methods of mass screening, handheld ECG devices have the advantage of providing a verifiable ECG trace that guidelines require for AF diagnosis and would therefore be preferred as screening tools. Certain patient groups, such as those with recent embolic stroke of uncertain source (ESUS), require more intensive monitoring for AF. Settings for screening include various venues in both the community and the clinic, but they must be linked to a pathway for appropriate diagnosis and management for screening to be effective. It is recognized that health resources vary widely between countries and health systems, so the setting for AF screening should be both country- and health system-specific. Based on current knowledge, this white paper provides a strong case for AF screening now while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base., (© 2017 American Heart Association, Inc.)