Another new trick
Over the past few decades we have seen some incredible advances in clinical medicine. Although the pace of pharmaceutical growth has slowed somewhat over recent years, impressive advances in modern technology have resulted in a number of diagnostic techniques and devices becoming widely available. Not only should we be aware of these new devices but we need to know how they work and how to interpret the data that they produce. However, just as new drugs have to be rigorously assessed, all medical equipment should have evidence-based data to substantiate its introduction and widespread use.
Bearing this in mind, I read with interest an article recently published in the Univadis Medical News service (click here). The article starts by proclaiming that "GPs should invest in a blood pressure monitor that also checks for atrial fibrillation, according to new NICE guidance". Now many of you may groan, especially if you have already just recently purchased an ambulatory blood pressure device. The good news is that this device is not too expensive at about £80. Despite this, according to NICE its use could save the NHS (in England) about £26 million every year.
The big gain here is through stroke prevention, by detecting previously undiagnosed atrial fibrillation while blood pressure is being routinely measured. It sounds a good idea, and has the prestige of NICE approval. However, cost may still be an issue, given that in order to maximise the potential benefit, every single device in primary care will probably need to be replaced. In big practices that could become a significant expense unless there is central funding. Furthermore, how reliable and durable are these new devices? Have they been rigorously tested against traditional blood pressure machines with the operator manually checking the pulse?
Nonetheless, the idea behind this device is intriguing. Detecting and managing AF is an important therapeutic area and preventing strokes should be high on our agenda. Reading this article also makes me think, what new clever piece of technology will come out next - watch this space!
Dr Harry Brown, editor-in-chief Univadis
By Dr Harry Brown