{
  "abstract": "Background Digital cardiac monitoring devices, including wearable and smartphone-based technologies, are increasingly used for atrial fibrillation (AF) detection. However, false-positive AF alerts may lead to unnecessary healthcare utilization, patient anxiety, and increased costs, with limited quantitative synthesis of this burden.Objective To systematically evaluate the impact of false-positive AF alerts from digital monitoring devices on healthcare utilization.Methods This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, and the Cochrane Library were searched from inception to December 2025 for observational studies and randomized trials reporting healthcare utilization outcomes following false-positive AF alerts generated by digital or wearable monitoring devices. Outcomes included emergency department (ED) visits, outpatient cardiology consultations, diagnostic testing, and hospital admissions. Study quality was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analyses were performed to pool odds ratios (ORs) or rate ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was quantified using the I2 statistic, and publication bias was assessed using funnel plots and Egger’s regression test.Results A total of 14 studies involving approximately 152,300 individuals using digital AF monitoring devices were included. False-positive AF alerts were associated with significantly higher healthcare utilization compared with true-negative alerts, including increased ED visits (pooled OR 2.21; 95% CI 1.74–2.81; I2 = 46%), outpatient cardiology consultations (OR 2.68; 95% CI 2.01–3.57; I2 = 51%), and diagnostic testing such as ECG or Holter monitoring (OR 3.12; 95% CI 2.34–4.17; I2 = 49%). Hospital admissions were also more frequent following false-positive alerts (OR 1.58; 95% CI 1.22–2.05; I2 = 38%). Subgroup analyses showed greater utilization among older adults and first-time device users. No significant publication bias was detected (Egger’s test, p > 0.10).Conclusions False-positive AF alerts from digital monitoring devices are associated with substantially increased healthcare utilization. These findings highlight the need for improved algorithm specificity and clearer clinical pathways to mitigate unnecessary resource use.",
  "authors": [
    {
      "affiliations": [
        "PAF Hospital Unit II, Islamabad, Pakistan"
      ],
      "name": "Jahanzeb Malik"
    },
    {
      "affiliations": [
        "PAF Hospital Unit II, Islamabad, Pakistan"
      ],
      "name": "Abida Perveen"
    }
  ],
  "title": "89 Healthcare utilisation associated with false-positive atrial fibrillation alerts from digital monitoring devices: a systematic review and meta-analysis",
  "uid": "c079f423-3487-5ca9-96c3-dedb8d825d47"
}