title: Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol.
abstract: BACKGROUND
  Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers.
  
  
  METHODS
  An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis).
  
  
  CONCLUSIONS
  If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines.
  
  
  BACKGROUND
  The study is registered as NCT01291953 (ClinicalTrials.gob).
authors.affiliation: Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Avda, Menéndez Pidal, s/n, Córdoba, 14004, Spain. luisangel.perula@gmail.com
authors.forename: Luis Á
authors.initials: LÁ
authors.lastname: Pérula-de-Torres
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Martínez-Adell
authors.forename: Virginia
authors.initials: V
authors.lastname: González-Blanco
authors.forename: José M
authors.initials: JM
authors.lastname: Baena-Díez
authors.forename: Enrique
authors.initials: E
authors.lastname: Martín-Rioboó
authors.forename: Juan M
authors.initials: JM
authors.lastname: Parras-Rejano
authors.forename: Jesús
authors.initials: J
authors.lastname: González-Lama
authors.forename: Remedios
authors.initials: R
authors.lastname: Martín-Alvarez
authors.forename: Roger
authors.initials: R
authors.lastname: Ruiz-Moral
authors.forename: José Á
authors.initials: JÁ
authors.lastname: Fernández-García
authors.forename: Modesto
authors.initials: M
authors.lastname: Pérez-Díaz
authors.forename: Joaquin
authors.initials: J
authors.lastname: Ruiz-de-Castroviejo
authors.forename: Carlos
authors.initials: C
authors.lastname: Pérula-de-Torres
authors.forename: Antonio
authors.initials: A
authors.lastname: Valero-Martín
authors.forename: Ana
authors.initials: A
authors.lastname: Roldán-Villalobos
authors.forename: Margarita
authors.initials: M
authors.lastname: Criado-Larumbe
authors.forename: Emili
authors.initials: E
authors.lastname: Burdoy-Joaquín
authors.forename: Montserrat
authors.initials: M
authors.lastname: Coma-Solé
authors.forename: Mercè
authors.initials: M
authors.lastname: Cervera-León
authors.forename: Lluís
authors.initials: L
authors.lastname: Cuixart-Costa
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods*; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000379:methods*; D011674:Pulse / Q000379:methods*; D055502:Secondary Prevention / Q000379:methods; D013030:Spain