2020/12/24
Keio University School of Medicine
Keio University Hospital
A research group led by Dr. Yoshinori Katsumata, a senior lecturer at the Keio University School of Medicine's Institute for Integrated Sports Medicine (at the time of the research: Department of Internal Medicine (Cardiology)), Senior Lecturer Shun Kohsaka, Associate Professor Seiji Takatsuki, and Professor Keiichi Fukuda of the Department of Internal Medicine (Cardiology) has announced the results of an observational study using data from a multi-center collaborative registry study on atrial fibrillation (hereinafter, the KiCS-AF registry). The study revealed that patient questionnaires are useful for understanding symptoms.
Atrial fibrillation is one of the most common types of arrhythmia and is known to be a risk factor for stroke, heart failure, and dementia. About half of the people who experience atrial fibrillation have symptoms such as palpitations and shortness of breath. Proactive treatment is recommended, especially for those with symptoms. In addition to drug therapy, ablation treatment using a cardiac catheter has become increasingly common in recent years.
Traditionally, determining "whether or not there are symptoms" of atrial fibrillation has been based on standard medical interviews by physicians. However, in clinical practice, there was a possibility that physicians were not able to accurately grasp the symptoms due to various factors such as time constraints and patient reticence.
Therefore, this research group used the KiCS-AF registry, established through the cooperation of Keio University Hospital and its affiliated hospitals, to verify whether there was a discrepancy between the physician's grasp of symptoms and the patient's perception of them, and if so, whether this discrepancy affected treatment choices. The patient's perception of symptoms was assessed using AFEQT, a patient-reported outcome measure used for quality of life (QOL) in atrial fibrillation.
An analysis of data from 1,173 patients who were aware of their symptoms revealed that in as many as 306 patients (26%), there was a discrepancy between the physician's medical interview and the patient's questionnaire results regarding symptoms. Specifically, although the patients believed they had symptoms, their physicians determined through medical interviews that they had "no" symptoms (under-recognition). In this under-recognition patient group, the rate of catheter ablation was 0.42 times lower compared to the group where physicians correctly recognized the patients' symptoms, suggesting that sufficient treatment may not have been provided.
This study not only demonstrated the need for physicians to make greater efforts to be more attentive to their patients but also suggested that incorporating patient questionnaires like AFEQT into clinical practice, in addition to medical interviews, could lead to the provision of treatment that is more aligned with patient needs. As we enter the era of AI-assisted medical care, such findings are expected to become increasingly important.
This research was published in the online edition of the international academic journal "JACC: Clinical Electrophysiology" on December 23, 2020 (U.S. Eastern Standard Time).
Please see below for the full press release.