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Diagnostic accuracy of ST-segment elevation myocardial infarction by various healthcare providers.
MedLine Citation:
PMID:  25465827     Owner:  NLM     Status:  Publisher    
BACKGROUND: This study aimed to compare the accuracy of ECG interpretation for diagnosis of STEMI by different groups of healthcare professionals involved in the STEMI program at our institution.
METHODS: We selected 21 ECGs from patients with typical symptoms of MI that were diagnosed with STEMI, and 10 ECGs of STEMI mimics. STEMI mimic ECGs were repeated in the package with a story of typical and atypical chest pain. ECGs were interpreted to diagnose STEMI and identify need for initiation of the cardiac catheterization lab (CCL). Participants identified confidence in STEMI recognition, and average number of ECGs read per week.
RESULTS: A total of 64 participants completed the study package. Cardiologists were more likely to provide correct interpretation compared to other groups. False positive diagnoses were more likely made by paramedics when compared to cardiologists (p<0.01). There was a positive correlation between increased exposure to ECGs and accurate STEMI diagnosis (r=0.482, p<0.001). A threshold of ≥20 ECGs read per week showed a statistically significant improvement in accuracy (p<0.001). Self-reported confidence correlated positively with accuracy (r=0.402, p=<0.001). Changing the ECG narrative of the STEMI mimic ECGs had a significant effect on interpretation between groups (p=0.043).
CONCLUSIONS: Our study showed that healthcare profession and number of ECGs reviewed per week are predictive of the accuracy of ECG interpretation of STEMI. Cardiologists are the most accurate diagnosticians, and are the least likely to falsely activate the CCL. Weekly exposure of ≥20 ECGs may improve diagnostic accuracy regardless of underlying experience.
Ashlay A Huitema; Tina Zhu; Mistre Alemayehu; Shahar Lavi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-6
Journal Detail:
Title:  International journal of cardiology     Volume:  177     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-3     Completed Date:  -     Revised Date:  2014-12-4    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  825-829     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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