Accuracy of general practitioners' readings of ECG in primary care

• Type: Article in International Scientific Journal
• Date: 2014

Authors

Paulo Santos (Author) FMUP; Paulo Pessanha (Author) FMUP; Manuel Viana (Author) FMUP; Manuel Campelo (Author) FMUP; José Pedro Nunes (Author) FMUP; Alberto Hespanhol (Author) FMUP; Filipe Macedo (Author) FMUP; Maria Luciana Couto (Author) FMUP

Journal

Title: Central European Journal of Medicine

Vol. 9 No. 3

Pages: 431-436

ISSN: 1895-1058

Publisher: De Gruyter Open

Indexing

ISI Web of Knowledge - 9 Citations

Scopus - 8 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

CORDIS: Health sciences > Medical sciences > Medicine > Family medicine ; Health sciences > Medical sciences > Medicine > Cardiology

Other information

Authenticus ID: P-009-N2K

DOI: 10.2478/s11536-013-0288-9

Abstract (EN): The electrocardiogram (ECG) is a diagnostic test commonly used in daily Primary Care practice. General Practitioners (GP) often feel unsure about their interpretation of ECGs, so they engage external services to provide it. To evaluate accuracy of ECG readings done by GPs by comparison with those done by a cardiologist as the gold standard. We studied 195 ECGs collected consecutively during first semester of 2010 in an urban Health Centre of Portugal. Each ECG was read by each physician and inter-observer agreement was evaluated. After coding by Novacode, sensitivity and specificity of GP's readings were calculated. Inter-observer agreement between GP readings was "good" with an intraclass correlation coefficient of 0.727 (CI 95%: 0.670-0.779). When compared with gold standard, GP achieved a "good" agreement with an intraclass correlation coefficient of 0.712 (CI 95%: 0.659-0.762). The overall accuracy of GP for detecting abnormalities was 81.0% (95%CI: 75.7-85.6%), with a sensitivity of 84.8% (95%CI: 77.3-90.6%) and a specificity of 77.5% (95%CI: 69.7-84.2%). For normal tests, accuracy was 79.9% (95%CI: 74.7-84.3). In the most prevalent classes of abnormalities, accuracy was higher than 90%. GP showed good skills in reading ECGs in their practice of Primary Care. Better attention should be given to ischemic abnormalities present on ECGs. Key message: General Practitioners demonstrate good skills for reading the ECGs of patients on a primary care centre when compared to the gold standard defined by a cardiologist reading.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6