Arrhythmias & electrophysiologyDiagnostic or prognostic study
Risk-Guided Screening for Atrial Fibrillation Using Electronic Health Records
- Prediction model development, external validation and prospective study
- machine learning (random forest)
- multinational external validation
- prospective screening study
- 15 sites
Authors' conclusion
The EHR-based machine learning model, FIND-AF 2.0, identifies a high-risk subpopulation for AF diagnosis among patients at elevated risk of stroke
Study context
- Population
- Participants ≥30 years without atrial fibrillation (AF), CHA2DS2-VASc ≥2 (men) or ≥3 (women); EHR cohorts in UK, Japan, Israel, Canada and Chinaprospective study, 15 sites
- Participants
- 1,923 participants
- Comparison
- High vs low FIND-AF 2.0 risk
- High FIND-AF 2.0 riskn = 1,021
- Low FIND-AF 2.0 riskn = 902reference
- Outcome
- Newly diagnosed AF (4 handheld ECG recordings/day for 3 weeks)
Performance
Newly diagnosed AF
Odds ratio
8.46
95% CI 3.35–21.40
P < 0.001
Events by group
High FIND-AF 2.0 risk vs Low FIND-AF 2.0 risk
OR 8.46 (95% CI 3.35–21.40); P < 0.001
As reported in the abstract
Further findings
| Outcome | High FIND-AF 2.0 risk | Low FIND-AF 2.0 risk |
|---|---|---|
| AF burden in high-risk detected cases | median 33.4% (IQR 5.1%–91.6%) | Not reported in the abstract |
- AF burden in high-risk detected cases — Initiated OAC
- 96.1%
- Prediction of new AF within 6 months (AUROC), by EHR cohort: UK AUROC 0.819 (95% CI 0.809-0.829)
- Prediction of new AF within 6 months (AUROC), by EHR cohort: Israel AUROC 0.835 (95% CI 0.828-0.842)
- Prediction of new AF within 6 months (AUROC), by EHR cohort: Japan AUROC 0.751 (95% CI 0.745-0.757)
- Prediction of new AF within 6 months (AUROC), by EHR cohort: Canada AUROC 0.747 (95% CI 0.741-0.753)
- Prediction of new AF within 6 months (AUROC), by EHR cohort: China AUROC 0.753 (95% CI 0.725-0.771)
Prediction of new AF within 6 months (AUROC), by EHR cohort
- AUROC>0.7 in men and women in all cohorts; improved performance vs CHA2DS2-VASc and C2HEST
Ischemic stroke in high FIND-AF 2.0 risk, AF, no anticoagulants (FinACAF registry, n=229 565)
- Ischemic stroke rate
- 6.0 events per 100 patient-years
Original publication
Risk-Guided Screening for Atrial Fibrillation Using Electronic Health Records. Circulation. Published 28 July 2026. doi:10.1161/circulationaha.126.079391
Summarised from the published abstract; every number is checked against it