Document Detail


An assessment of the ability of diplomates, practitioners, and students to describe and interpret recordings of heart murmurs and arrhythmia.
MedLine Citation:
PMID:  11817055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The ability of clinicians, ie, 10 veterinary students, 10 general practitioners, and 10 board certified internists, to describe and interpret common normal and abnormal heart sounds was assessed. Recordings of heart sounds from 7 horses with a variety of normal and abnormal rhythms, heart sounds, and murmurs were analyzed by digital sonography. The perception of the presence or absence of the heart sounds S1, S2, and S4 was similar for clinicians irrespective of their level of training and was in agreement with the sonographic interpretation on 89, 82, and 78% of occasions, respectively. However, practitioners were less likely to correctly describe the presence of S3. The heart rhythm was correctly described as being regular or irregular on 89% of occasions, and this outcome was not affected by level of training. Differentiation of the type of irregularity was less reliable. The perception of the intensity of a heart murmur was accurate and correlated with the grade assigned in the living horses, R2 = .68, and with sonographic measurements of the murmur's intensity, R2 = .69. Clinicians overestimated the duration of cardiac murmurs, particularly that of the loud systolic murmur. Only diplomates could reliably differentiate systolic from diastolic murmurs. The ability to diagnose the underlying cardiac problem was significantly affected by training; diplomates, practitioners, and undergraduates made the correct diagnosis on 53, 33, and 29% of occasions, respectively. The poor diagnostic ability of practitioners and the lack of improvement in diagnostic skill after the 2nd year of veterinary school emphasizes the need for better teaching of these skills. Digital sonograms that combine sound files with synchronous visual interpretations may be useful in this regard.
Authors:
J M Naylor; L M Yadernuk; J W Pharr; J S Ashburner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of veterinary internal medicine / American College of Veterinary Internal Medicine     Volume:  15     ISSN:  0891-6640     ISO Abbreviation:  J. Vet. Intern. Med.     Publication Date:    2001 Nov-Dec
Date Detail:
Created Date:  2001-12-05     Completed Date:  2002-04-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8708660     Medline TA:  J Vet Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  507-15     Citation Subset:  IM    
Affiliation:
Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada. jon.naylor@usask.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Arrhythmias, Cardiac / diagnosis,  veterinary*
Diagnosis, Differential
Education, Veterinary
Heart Auscultation / standards,  veterinary*
Heart Murmurs / diagnosis,  veterinary*
Horse Diseases / diagnosis*
Horses
Humans
Middle Aged
Observer Variation
Professional Competence
Veterinary Medicine / standards*
Comments/Corrections
Comment In:
J Vet Intern Med. 2001 Nov-Dec;15(6):505-6   [PMID:  11817054 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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