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Diagnostic accuracy

Smartphone PPG to detect atrial fibrillation

Proesmans T, Mortelmans C, Van Haelst R, et al. · JMIR mHealth and uHealth · 2019

Open access · cc by · source: Europe PMC

FibriCheck PPG showed ~96% sensitivity and specificity versus cardiologist ECG on analysable traces.

Study at a glance

Design
Cross-sectional — Diagnostic accuracy vs 12-lead ECG in primary care
N
N=223 · 241 enrolled; 223 analysed after exclusions
Population
Primary-care patients screened for atrial fibrillation with FibriCheck PPG
Outcome
Sensitivity and specificity of mobile PPG for AF vs 12-lead ECG

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

241 enrolled; 223 analysed. Sensitivity 95.6%, specificity 96.6% vs ECG.

Methodology

Primary-care patients underwent FibriCheck PPG and 12-lead ECG; accuracy calculated after excluding pacing and poor signals.

Limitations

Needs adequate signal quality; pacing excluded; PPV/NPV depend on prevalence.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsDiagnostic Accuracyconcept

    Phone pulse waveforms can detect atrial fibrillation accurately versus ECG in clinic samples.

    Smartphone photoplethysmography detected atrial fibrillation with sensitivity about 95.6% and specificity about 96.6% versus ECG in an analysed clinic sample (adequate signal required; pacing excluded).

    Evidence for the claim as stated.

  • QualifiesDiagnostic Accuracyconcept

    A multiplex assay can identify Staphylococcus from blood cultures with very high accuracy.

    A multiplex molecular assay on monomicrobial blood cultures identified Staphylococcus at genus level with sensitivity about 99.4% and specificity about 99.7% in a large evaluated set.

    Scope note — different modality — PPG AF screening, not microbiology ID

    Limits the claim's scope: a different population, assay, or outcome.

  • QualifiesDiagnostic Accuracyconcept

    In GP care, CA125 looks accurate but a positive rarely means ovarian cancer when disease is rare.

    In GP care, CA125 ≥35 U/ml for ovarian cancer showed sensitivity about 77%, specificity about 93.8%, and AUC about 0.92, but PPV was only about 10.1% because incidence was about 0.9%—illustrating prevalence’s grip on predictive value.

    Scope note — higher-prevalence clinic AF sample — PPV/NPV not transportable as raw sensitivities

    Limits the claim's scope: a different population, assay, or outcome.

  • QualifiesDiagnostic Accuracyconcept

    Higher blood GFAP and NfL associate with later dementia risk — prognosis, not same-day diagnosis.

    In UK Biobank, higher baseline plasma GFAP and NfL were associated with roughly doubled hazards of incident dementia over ~13 years, with incremental discrimination when added to demographic risk scores—prognostic biomarker performance, not a bedside diagnostic rule-in test.

    Scope note — different task — detecting current AF vs ECG, not forecasting dementia

    Limits the claim's scope: a different population, assay, or outcome.

  • SupportsDiagnostic Accuracyconcept

    Point-of-care classification accuracy (AF, blood culture ID, sickle cell, pain subtype) is not the same claim as low-prevalence screening PPV or long-horizon prognostic discrimination. Mixing sensitivities with hazards or PPVs invents a false head-to-head.

    Evidence for the claim as stated.

  • SupportsDiagnostic Accuracyconcept

    High sensitivity/specificity in a selected clinic sample does not guarantee useful predictive values in a low-prevalence screening population—the CA125 GP analysis is the cautionary case in this library.

    Evidence for the claim as stated.

  • Primary-care FibriCheck PPG, after excluding pacing and poor signals, classified atrial fibrillation against 12-lead ECG with sensitivity 95.6% and specificity 96.6% (241 enrolled, 223 analysed). Signal quality is a prerequisite; PPV and NPV still depend on prevalence in the waiting room being tested.

    Evidence for the claim as stated.

  • The five papers are tuned to different prevalences and harms of error, so a 'good' sensitivity/specificity pair is not portable. CA125's 77%/93.8% at 0.9% incidence yields PPV 10.1% — a primary-care rare-disease problem. StEP's 95%/93% pinprick figures come from specialist clinics where neuropathic pain is common. FibriCheck's 95.6%/96.6% is versus ECG after dropping poor signals. Blood-culture 99.4%/99.7% is laboratory identification, not community screening. Frailty's 99.1% specificity describes a ~1.1% trajectory class, not a test you run on everyone.

    Evidence for the claim as stated.

  • FibriCheck PPG was compared with 12-lead ECG in primary care (241 enrolled, 223 analysed), yielding sensitivity 95.6% and specificity 96.6% after excluding pacing and poor signals. That is agreement with a reference standard, not a blinded placebo-controlled treatment trial. PPV and NPV still depend on prevalence.

    Evidence for the claim as stated.

  • Who is blinded, and whether a placebo exists, disagrees across the four papers. SEPP blinded the collector while comparing an identifiable parenting programme with standard care. Partners PrEP adherence work sits inside a placebo-controlled antiretroviral trial but reports UPC/MEMS adherence (99.1%/97.2%), not a placebo-subtracted efficacy estimate. The child-care zBMI trial is an open cluster-style programme contrast. FibriCheck does not assign a treatment at all. One method label is doing four jobs.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

History

When this study was placed

Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.

  1. 2026-09-14

    Placed as a scope qualifier on Diagnostic Accuracy

    A multiplex molecular assay on monomicrobial blood cultures identified Staphylococcus at genus level with sensitivity about 99.4% and specificity about 99.7% in a large evaluated set.

  2. 2026-09-14

    Placed as a scope qualifier on Diagnostic Accuracy

    In GP care, CA125 ≥35 U/ml for ovarian cancer showed sensitivity about 77%, specificity about 93.8%, and AUC about 0.92, but PPV was only about 10.1% because incidence was about 0.9%—illustrating prevalence’s grip on predictive value.

  3. 2026-09-14

    Placed as a scope qualifier on Diagnostic Accuracy

    In UK Biobank, higher baseline plasma GFAP and NfL were associated with roughly doubled hazards of incident dementia over ~13 years, with incremental discrimination when added to demographic risk scores—prognostic biomarker performance, not a bedside diagnostic rule-in test.

  4. 2026-09-14

    Placed as supporting evidence on Diagnostic Accuracy

    High sensitivity/specificity in a selected clinic sample does not guarantee useful predictive values in a low-prevalence screening population—the CA125 GP analysis is the cautionary case in this library.

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