180 Chapter 5 Target population Adults at risk of cardiovascular disease with a watch with ECGapp Test • Watch with ECG-app • Purpose: to detect atrial fibrillation • Role in test-management pathway: triage Test result • Positive • Negative • Inconclusive Including undesirable consequences (burden, side effects, societal costs) related to the test • No burden, side effects, adverse events and/or complications Impact on peopleimportant outcomes • TP: (early) detection and treatment of atrial fibrillation: reduction of stroke risk possible overtreatment (unnecessary ablation procedures) treatment side effects increase of costs • FP: unnecessary consult and subsequent tests unnecessary anxiety increase of costs • TN: correct reassurance, no further consequences • FN: incorrect reassurance increased stroke risk Interpretation of test results and subsequent management • Positive: consult primary care physician (and eventually start treatment or referral) • Negative: no consequences • Inconclusive: repeat test Including undesirable consequences (burden, side effects, societal costs) related to management • Costs and time of primary care consult and treatment or referral • Burden, adverse events and side effects of treatment (a). Figure 2. Test-management pathway examples on (a) self-testing, (b) screening, (c) diagnostic testing, and (d) follow-up testing. TP: true positives; FP: false positives; TN: true negatives; FN: false negatives. Note: The examples provided are intended solely as such and may not necessarily reflect the cut-off values or recommended management in currently applicable guidelines.
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