Modeling of Non-Invasive Methods of Remote Health Screening in Cardiovascular Diseases

Abstract

Purpose: to develop a model of non-invasive methods for remote health screening in patients with cardiovascular diseases based on international experience. Research objectives: to analyze international experience in the application of non-invasive methods for remote screening in cardiovascular diseases; to substantiate the feasibility of their use in the relevant patient population; to define criteria for selecting devices and software; to formalize patient pathways within the remote screening system; and to propose practical models for its implementation. Materials and methods. The study was designed as a structured analytical review combined with conceptual and scenario-based modeling. The source base included international clinical trials, systematic reviews, professional society guidelines, and regulatory documents dealing with three priority domains: detection of atrial fibrillation with wearable photoplethysmography and ECG-based solutions followed by mandatory electrocardiographic confirmation; remote blood pressure assessment, including cuffless technologies; and non-invasive remote observation in chronic heart failure aimed at the early detection of clinical deterioration. The analytical framework combined thematic synthesis, comparative review, and process modeling. For each technological scenario, the following dimensions were assessed: target condition, class of device, physiological signal, confirmation protocol, suitability for primary health care, risk of false-positive and false-negative results, data quality requirements, interoperability, auditability, and cybersecurity. Particular attention was paid to the distinction between a digital suspicion signal and a clinically confirmed result, as well as to the organizational role of primary health care in triage, referral, and follow-up. Results. The review demonstrated that effective remote screening programs in cardiovascular care are built around a standardized clinical chain: signal acquisition, data quality control, triage, confirmatory testing, and clinical decision-making. Regardless of the class of technology, this chain determines the balance between yield, safety, and organizational manageability. Three domains appeared to be the most mature. First, targeted atrial fibrillation screening in high-risk groups can be supported by wearable PPG solutions and personal ECG devices, but only when all diagnosis-relevant signals are verified by a standard ECG method. Second, remote screening for arterial hypertension remains most clinically reliable when based on validated home cuff devices, whereas cuffless technologies should currently be positioned mainly as pre-screening or trend-monitoring tools because of concerns related to calibration, drift, transportability of accuracy, and methodological heterogeneity. Third, in chronic heart failure, multiparametric remote monitoring using body weight, heart rate, activity, and symptom-related inputs may support earlier recognition of deterioration, but only if a predefined escalation protocol exists. Based on the synthesis, five domains of device selection criteria were identified: clinical fit-for-purpose, validity and reproducibility, resilience to artifacts and missingness, regulatory acceptability and safety, and scalability at the primary care level. For software and digital platforms, the critical requirements included interoperability with health information systems, data quality management, logging of clinically relevant events, cybersecurity, and algorithm version control. Three patient pathway schemes were formalized for atrial fibrillation, arterial hypertension, and chronic heart failure, and four practical implementation models were proposed for Ukraine. Among them, the most realistic pilot options were primary-care-oriented remote screening for hypertension and targeted remote screening for atrial fibrillation in risk groups. Conclusions. Non-invasive remote screening in cardiovascular diseases should be interpreted not as isolated use of consumer devices but as a complex clinical and organizational intervention. Primary health care is the key coordinating level because it enables patient selection, onboarding, signal triage, referral for confirmatory diagnostics, and subsequent risk-factor management. For the Ukrainian health system, priority should be given to implementation models characterized by a high prevalence of the target condition, a clear confirmation protocol, and a predictable resource burden.