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Journals / Türkiye Acil Tıp Dergisi / 2007 / Cilt: 7 - Sayı: 2

An analysis of accuracy and reliability of emergency department ECG interpretations

Acil serviste yorumlanan elektrokardiyografilerin doğruluk ve güvenilirliğinin değerlendirilmesi

Murat ERSEL
İsmet PARLAK
Fidan SEVER
Mustafa SEVER
Özgür KARCIOĞLU
Özgür ASLAN
Pages
56–63
Publication Date
2022-11-05
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Total rate of discordance was 49.2% including misinterpretations of normal ECGs (n=148, p

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives: To determine the accuracy and reliability of emergency physician (EP) interpretations of ECGs obtained in the emergency department (ED).
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Key Findings & Data:Materials and Methods: 300 consecutive adult patients of whom ECGs had been obtained in the ED were enrolled in the study.
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Conclusion & Impact:Total rate of discordance was 49.2% including misinterpretations of normal ECGs (n=148, p
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objectives: To determine the accuracy and reliability of emergency physician (EP) interpretations of ECGs obtained in the emergency department (ED). Materials and Methods: 300 consecutive adult patients of whom ECGs had been obtained in the ED were enrolled in the study. One patient was excluded due to misreplacement of ECG electrodes. Tracings were blind¬ly analyzed and allocated into three categories (Category I: clinically insignificant abnormalities, Category II: potentially significant abnormalities and Category III: clinically significant ECG pathologies) by an EP and a sec¬ond interpretation by a staff cardiologist as the gold standard. ECG interpretation concordance of EP and cardi¬ologist was evaluated using kappa test. Results: Discrepancies of interpretations of abnormal ECGs between EP and cardiologists were 42.2%. Ten (3.3%} of these were within Category III, 22 (7.3%) were in Category II and 95 (31.6%) in Category I. The most frequently missed findings were nonspecific ST-T segment elevation and atrial enlargment or hypertrophy. Total rate of discordance was 49.2% including misinterpretations of normal ECGs (n=148, p

Özet

Giriş: Bu çalışmadaki amacımız acil servis (AS) hekimlerince yorumlanan elektrokardiyografilerin (EKG) doğruluğunu ve güvenilirliğini değerlendirmektir. Gereç ve Yöntem: AS'te ardışık olarak EKG'si çekilen 301 erişkin hasta çalışmaya alındı. Olgulardan biri uygun¬suz EKG çekimi nedeniyle çalışmadan çıkartıldı. Olguların EKG'leri kardiyoloji uzmanı (KU) ve acil tıp uzmanı (ATU) tarafından birbirinden bağımsız ve kör yöntemle üç kategoride değerlendirildi (kategori I: klinik önemi olmayan veya minör, kategori II: potansiyel klinik önemi olan, kategori III: klinik önemi olan veya majör). KU tarafından yapılan yorumlar altın standart olarak kabul edildi. KU ve ATU tarafından değerlendirilen EKG'lerin yorum uyumlu¬luğu kappa testi kullanılarak karşılaştırıldı. Bulgular: Anormal EKG'leri yorumlamada KU ile ATU arasındaki uyumsuzluk oranı %42.2 saptandı. Bunlardan 10'u (%3.3) majör, 22'si (%7.3) potansiyel klinik önemi olan, 95'i (%31.6) minör EKG bulguları içerirken, 21 'i (%7.0) yanlış yorumlanmış normal EKG'lerdi. KU ile ATU arasındaki toplam uyumsuzluk %49.2'dir (n=148, p

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Cite This Article

ERSEL, M., PARLAK, İ., SEVER, F., SEVER, M., KARCIOĞLU, Ö., ASLAN, Ö. (2022). An analysis of accuracy and reliability of emergency department ECG interpretations. Türkiye Acil Tıp Dergisi, Cilt: 7 - Sayı: 2, 56–63. https://ajindex.com/articles/626163

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References (15)

  1. Green GB, Hill PM. Cardiovascular disease: approach to chest pain and possible myocardial ischemia. In: Tintinalli JE, Kelen GD, Stapczynski JS, editors. A com prehensive study guide: textbook of emergency medicine. 5th ed. North Carolina: Me Graw-Hill
  2. p. 341-52. 2.Schweitzer P. The electrocardiographic diagnosis of acute myocardial infarction in the thrombolytic era: Curriculum in cardiology. Am Heart J 1990
  3. Lee TH, Rouan GW, Weisberg MC, Brand DA, Acampora D, Stasiulewicz C, et al. Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room. Am J Cardiol 1987
  4. Sanders AB, Cummins RO, Aufderheide TP. The acute coronary syndromes, including acute myocardial infarction. In: Sanders AB, editor. Textbook of advanced cardiac life support. USA: American Heart Association
  5. p. 12-23. 5.Lee TH, Cook EF, Weisberg M, Sargent RK, Wilson C, Goldman L. Acute chest pain in the emergency room: Identification and examination of low risk patients. Arch Intern Med 1985
  6. Chung EK. Pocket guide to ECG diagnosis. USA: Blackwell Science
  7. p. 1-23. 7.Fisch C. Electrocardiography. In: Braunwald E, editor. Heart disease: A Textbook of cardiovascular medicine. 5th ed. Pennsylvania: W.B. Saunders
  8. p. 108-51. 8.Sanders AB, Cummins RO, Aufderheide TP. Essentials of ACLS, Acute myocarial infarction. In: Textbook of advanced cardiac life support. USA: American Heart Association
  9. p. 47-58. 9.Isabel dos Santos Silva. Cancer epidemiology principles and methods. IARWHO. Lyon: France, 1999. p. 11-44. 10.Nayak H. Cardiology: ECG Essentials. In: Top 30 problems in emergency medicine. A rapid pocket reference and teaching tool, 1st ed. USA: Emergency Medicine Residents'Association
  10. p. 15-7. 11.Kuhti M, Morgan MT, Hoffman JR. Quality assurance in emergency department: Evaluation of the ECG review process. Ann Emerg Med 1992
  11. Snoey ER.Housset B.Guyon P, et al. Analysis of emergency department interpretation of ECGs.JAccid Emerg Med 1994
  12. ll:149-53. 13.Todd KH, Hoffman JR
  13. Morgan MT. Effect of cardiologist ECG review on emer¬ gency department practice. Ann Emerg Med 1996
  14. Gordon GS, Silverstein S. Ischemic heart disease. In: Rosen P, Barkin R, Baker R, et al. editors. Emergency medicine: Concepts and clinical practice. 2nd ed. St.Louis: Mosby
  15. p. 1329-67. 15.Brush JE, Brand DA, Acampora D, Chalmer.B, Wackers FJ. Use of the initial