The CIRCULAR model: advancing public health through citizen science initiated clinical and mechanistic research in atrial fibrillation

Citizen science is a transformative approach to advancing health research by bridging the gap between researchers and the public. The Dutch CIRCULAR model, which addresses atrial fibrillation (AF), the most common cardiac arrhythmia worldwide, offers a unique example of applying citizen science in biomedical and public health research. The project was established to systematically include people with AF and their families as partners in research, ensuring that their lived experiences inform priorities, study designs, and interventions. A central role is played by the online health community of the AFIP foundation, which engages the AF community through blog articles, forums, social media, and outreach campaigns. These activities stimulate dialogue, enhance health literacy, empower individuals to contribute hypotheses and solutions, and function as a marketing strategy to attract and retain diverse participants. By sharing outcomes through open-access formats and direct communication with participants, CIRCULAR creates a feedback loop between citizens and researchers that fuels new research directions in AF. Early activities have demonstrated the value of this approach. Patient-reported triggers and suppressors of AF episodes, including psychological stress and lifestyle factors, informed laboratory investigations and led to the co-design of clinical interventions such as dietary programs. These examples illustrate how co-creation can shape both preclinical and clinical research as well as citizen and student education. This review discusses how citizen science is conceptualized and implemented in the CIRCULAR model, presents ongoing and future activities, and reflects on the added value of patient involvement for public health and biomedical innovation. By embedding citizens throughout the research process, and actively engaging them through targeted outreach, CIRCULAR advances patient-centered innovation, strengthens empowerment and health literacy, and provides lessons for future participatory initiatives in complex chronic disease research.