Diagnostic accuracy of smart gadgets/wearable devices in detecting atrial fibrillation: A systematic review and meta-analysis

Summary Background Recently, smart devices have been used for medical purposes, particularly to screen for atrial fibrillation. However, current data on the diagnostic performance of these devices are scarce. Aims We performed a systemic review and meta-analysis to assess the accuracy of atrial fibrillation diagnosis by smart gadgets/wearable devices. Methods We comprehensively searched the MEDLINE, EMBASE and Cochrane databases for all works since the inception of each database until January 2020. Included in this review were published observational studies of the diagnostic accuracy of smartphones or smartwatches in detecting atrial fibrillation. We calculated the area under the summary receiver operating characteristic curves and pooled sensitivities and specificities. Results Participants in our study were from the general population or were patients with underlying atrial fibrillation. In the overall analyses, the areas under the summary receiver operating characteristic curves were 0.96 and 0.94 for smartphones and smartwatches, respectively. Smartphones had a sensitivity of 94% and a specificity of 96%, and smartwatches showed similar diagnostic accuracy, with a specificity of 94% and a sensitivity of 93%. In subgroup analyses, we found no difference in diagnostic accuracy between photoplethysmography and single-lead electrocardiography. Conclusions This study suggests that smart devices have similar diagnostic accuracies. Regarding atrial fibrillation detection methods, there was also no difference between photoplethysmography and single-lead electrocardiography. However, further studies are warranted to determine their clinical implications in atrial fibrillation management.