Heart sensors in shopping trolleys? I’d rather have Mint Slices in the GP’s rooms, thanks.
Ah, shopping trolleys.
I’ve ridden in them, pushed them, pulled them, danced with them, rammed them not so accidentally into the carts of people I’ve wanted to flirt with, and bashed them totally accidentally into cars, usually my own.
A couple of things I’ve never done is applied for a research grant to study them, used them as a health-monitoring device, or written about them.
Well, today, gentle reader, I break my duck on at least one score.
UK researchers have put ECG sensors into the handles of supermarket trollies to see if they could identify people with atrial fibrillation.
Now, speaking as someone with AF (well controlled by medication, thanks for asking) I can honestly say that it is perfectly obvious to me when I am out of sinus rhythm because it feels weird. Apparently, this is not everyone’s experience. Apparently, most people have no clue.
And given AF increases the risk of stroke five-fold, and many people only discover they have AF after they have a stroke, the researchers decided to investigate how to screen a population without the nuisance of going into a healthcare setting.
Ten trolleys had a sensor placed in the handle and were used across four supermarkets with pharmacies in Liverpool during the two-month study.
Shoppers were asked to use a modified trolley and hold the handlebar for at least 60 seconds. If the sensor did not detect an irregular heartbeat, it lit up green. These participants had a manual pulse check by a researcher to confirm there was no atrial fibrillation.
If an irregular heartbeat was found, the sensor lit up red. The in-store pharmacist then did a manual pulse check and another sensor reading using a standalone bar not attached to a trolley with the participant standing still.
The study cardiologist reviewed the ECG recordings of participants with a red light and/or irregular pulse. Participants were informed of the results, which were: 1) no atrial fibrillation; 2) unclear ECG and an invitation to repeat the measurement; or 3) atrial fibrillation confirmed and a cardiologist appointment within two weeks.
“A total of 2155 adults used a shopping trolley. ECG data were available for 220 participants who either had a red light on the sensor and/or an irregular pulse, suggesting AF. After ECG review by the study cardiologist, there was no evidence of AF in 115 participants, 46 recordings were unclear, and AF was diagnosed in 59 participants,” the researchers reported.
“The average age of the 59 participants with AF was 74 years and 43% were women. Of those, 20 already knew they had AF and 39 were previously undiagnosed.”
I don’t know about you, dear reader, but I’m not sure I would agree to this kind of experience.
“Doing your weekly Big Shop? Would you care to find out if you have a life-threatening chronic condition while picking up your Marathon spring rolls and your TENA, ladies?”
No, actually. No. I want some psychological preparation for that kind of investigation, and I want my GP sitting next to me, holding my hand and telling me everything’s going to be okay.
Especially as three analyses of the data found that only one-quarter to one-half of those found to have AF according to their shopping trolley and/or manual pulse check actually had the condition (i.e. there were a high number of false positives); and that around half of actual AF cases would be missed using this method (i.e. false negatives).
“Nearly two-thirds of the shoppers we approached were happy to use a trolley, and the vast majority of those who declined were in a rush rather than wary of being monitored,” said author Professor Ian Jones.
“This shows that the concept is acceptable to most people and worth testing in a larger study. Before we conduct SHOPS-AF II, some adjustments are needed to make the system more accurate. For example, having a designated position on the bar to hold onto, as hand movement interfered with the readings. In addition, ESC Guidelines require just a 30-second ECG to diagnose AF, so we aim to find a sensor that will halve the time shoppers need to continuously hold the bar.
“Checking for AF while people do their regular shopping holds promise for preventing strokes and saving lives,” he concluded.
“A crucial aspect is providing immediate access to a health professional who can explain the findings and refer patients on for confirmatory tests and medication if needed.”
What’s next? Tap, tap. “Shopper in the biscuits aisle, are you sure you want that packet of Mint Slices? According to your trolley your blood sugar is already outside normal parameters.”
Healthcare in healthcare settings, thanks. If that means making healthcare settings better, then by all means, go for it.
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