Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram

Andrew Cairns, Raymond Bond, Dewar Finlay, Cathal, J Breen, Daniel Guldenring, Robert Gaffney, Pat Henn, Aaron Peace

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Background: Cardiovascular disease (CVD) kills 17 million people per year. The 12-lead Electrocardiogram (ECG) is an important diagnostic support tool to detect cardiac disease. Up to 33% of ECGs are incorrectly interpreted and clinicians often impulsively provide a diagnosis based on their first impression. It is therefore imperative to optimise how physicians interpret the 12-lead ECG. The standard presentation for the 12-lead ECG was developed over 70 years ago and currently presents the reader with all 12 lead signals on paper. This presentation format delivers a significant cognitive load. We hypothesise that ECG interpretation errors will be reduced using an algorithmic web-based user interface to facilitate a systematic approach to ECG interpretation. Methods: Following a literature review and interviews with expert clinicians and teaching professionals, a set of interactive questions and prompts were developed to guide a reader through a series of sub-tasks when interpreting an ECG. This has been named ‘Interactive Progressive based Interpretation’ (IPI). This system runs on touch screen devices to recreate an algorithmic approach to aid ECG interpretation. The IPI system was implemented using emerging web technologies, i.e. HyperText Markup Language (HTML5), JavaScript and Cascading Style Sheets (CSS3). Using this model, the 12-lead ECG is segmented into five parts and presented over five web pages. Page one presents the rhythm strip, page two presents lead II, page three presents all limb leads, page four presents the precordial leads and the last page presents the full 12-lead ECG. Each page displays a prompt and a series of questions that require input before the reader can ‘progress’ to the next page.Results: When comparing preliminary results with meta-analysis from studies in ECG interpretation competency [1], using Chi-square test (p-value <0.01), the IPI system has improved interpretation accuracy from 40% to 57%. Conclusion: A new algorithmic model has been proposed to aid ECG interpretation where interpreters systematically and sequentially interpret the 12-lead ECG as a series of sub-tasks.
LanguageEnglish
Title of host publicationUnknown Host Publication
Number of pages1
Publication statusPublished - 26 Oct 2015
Event7th Annual Translational Medicine Conference - Derry/Londonderry
Duration: 26 Oct 2015 → …

Conference

Conference7th Annual Translational Medicine Conference
Period26/10/15 → …

Fingerprint

Electrocardiography
Lead
Hypermedia
Chi-Square Distribution
Meta-Analysis
Heart Diseases
Teaching
Cardiovascular Diseases
Language
Extremities
Interviews
Technology
Physicians
Equipment and Supplies

Keywords

  • ECG
  • Health informatics
  • decision support

Cite this

Cairns, A., Bond, R., Finlay, D., Breen, C. J., Guldenring, D., Gaffney, R., ... Peace, A. (2015). Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram. In Unknown Host Publication
Cairns, Andrew ; Bond, Raymond ; Finlay, Dewar ; Breen, Cathal, J ; Guldenring, Daniel ; Gaffney, Robert ; Henn, Pat ; Peace, Aaron. / Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram. Unknown Host Publication. 2015.
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title = "Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram",
abstract = "Background: Cardiovascular disease (CVD) kills 17 million people per year. The 12-lead Electrocardiogram (ECG) is an important diagnostic support tool to detect cardiac disease. Up to 33{\%} of ECGs are incorrectly interpreted and clinicians often impulsively provide a diagnosis based on their first impression. It is therefore imperative to optimise how physicians interpret the 12-lead ECG. The standard presentation for the 12-lead ECG was developed over 70 years ago and currently presents the reader with all 12 lead signals on paper. This presentation format delivers a significant cognitive load. We hypothesise that ECG interpretation errors will be reduced using an algorithmic web-based user interface to facilitate a systematic approach to ECG interpretation. Methods: Following a literature review and interviews with expert clinicians and teaching professionals, a set of interactive questions and prompts were developed to guide a reader through a series of sub-tasks when interpreting an ECG. This has been named ‘Interactive Progressive based Interpretation’ (IPI). This system runs on touch screen devices to recreate an algorithmic approach to aid ECG interpretation. The IPI system was implemented using emerging web technologies, i.e. HyperText Markup Language (HTML5), JavaScript and Cascading Style Sheets (CSS3). Using this model, the 12-lead ECG is segmented into five parts and presented over five web pages. Page one presents the rhythm strip, page two presents lead II, page three presents all limb leads, page four presents the precordial leads and the last page presents the full 12-lead ECG. Each page displays a prompt and a series of questions that require input before the reader can ‘progress’ to the next page.Results: When comparing preliminary results with meta-analysis from studies in ECG interpretation competency [1], using Chi-square test (p-value <0.01), the IPI system has improved interpretation accuracy from 40{\%} to 57{\%}. Conclusion: A new algorithmic model has been proposed to aid ECG interpretation where interpreters systematically and sequentially interpret the 12-lead ECG as a series of sub-tasks.",
keywords = "ECG, Health informatics, decision support",
author = "Andrew Cairns and Raymond Bond and Dewar Finlay and Breen, {Cathal, J} and Daniel Guldenring and Robert Gaffney and Pat Henn and Aaron Peace",
year = "2015",
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Cairns, A, Bond, R, Finlay, D, Breen, CJ, Guldenring, D, Gaffney, R, Henn, P & Peace, A 2015, Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram. in Unknown Host Publication. 7th Annual Translational Medicine Conference, 26/10/15.

Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram. / Cairns, Andrew; Bond, Raymond; Finlay, Dewar; Breen, Cathal, J; Guldenring, Daniel; Gaffney, Robert; Henn, Pat; Peace, Aaron.

Unknown Host Publication. 2015.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

TY - GEN

T1 - Interactive computersied approach to guide human interpretation of the 12-lead electrocardiogram

AU - Cairns, Andrew

AU - Bond, Raymond

AU - Finlay, Dewar

AU - Breen, Cathal, J

AU - Guldenring, Daniel

AU - Gaffney, Robert

AU - Henn, Pat

AU - Peace, Aaron

PY - 2015/10/26

Y1 - 2015/10/26

N2 - Background: Cardiovascular disease (CVD) kills 17 million people per year. The 12-lead Electrocardiogram (ECG) is an important diagnostic support tool to detect cardiac disease. Up to 33% of ECGs are incorrectly interpreted and clinicians often impulsively provide a diagnosis based on their first impression. It is therefore imperative to optimise how physicians interpret the 12-lead ECG. The standard presentation for the 12-lead ECG was developed over 70 years ago and currently presents the reader with all 12 lead signals on paper. This presentation format delivers a significant cognitive load. We hypothesise that ECG interpretation errors will be reduced using an algorithmic web-based user interface to facilitate a systematic approach to ECG interpretation. Methods: Following a literature review and interviews with expert clinicians and teaching professionals, a set of interactive questions and prompts were developed to guide a reader through a series of sub-tasks when interpreting an ECG. This has been named ‘Interactive Progressive based Interpretation’ (IPI). This system runs on touch screen devices to recreate an algorithmic approach to aid ECG interpretation. The IPI system was implemented using emerging web technologies, i.e. HyperText Markup Language (HTML5), JavaScript and Cascading Style Sheets (CSS3). Using this model, the 12-lead ECG is segmented into five parts and presented over five web pages. Page one presents the rhythm strip, page two presents lead II, page three presents all limb leads, page four presents the precordial leads and the last page presents the full 12-lead ECG. Each page displays a prompt and a series of questions that require input before the reader can ‘progress’ to the next page.Results: When comparing preliminary results with meta-analysis from studies in ECG interpretation competency [1], using Chi-square test (p-value <0.01), the IPI system has improved interpretation accuracy from 40% to 57%. Conclusion: A new algorithmic model has been proposed to aid ECG interpretation where interpreters systematically and sequentially interpret the 12-lead ECG as a series of sub-tasks.

AB - Background: Cardiovascular disease (CVD) kills 17 million people per year. The 12-lead Electrocardiogram (ECG) is an important diagnostic support tool to detect cardiac disease. Up to 33% of ECGs are incorrectly interpreted and clinicians often impulsively provide a diagnosis based on their first impression. It is therefore imperative to optimise how physicians interpret the 12-lead ECG. The standard presentation for the 12-lead ECG was developed over 70 years ago and currently presents the reader with all 12 lead signals on paper. This presentation format delivers a significant cognitive load. We hypothesise that ECG interpretation errors will be reduced using an algorithmic web-based user interface to facilitate a systematic approach to ECG interpretation. Methods: Following a literature review and interviews with expert clinicians and teaching professionals, a set of interactive questions and prompts were developed to guide a reader through a series of sub-tasks when interpreting an ECG. This has been named ‘Interactive Progressive based Interpretation’ (IPI). This system runs on touch screen devices to recreate an algorithmic approach to aid ECG interpretation. The IPI system was implemented using emerging web technologies, i.e. HyperText Markup Language (HTML5), JavaScript and Cascading Style Sheets (CSS3). Using this model, the 12-lead ECG is segmented into five parts and presented over five web pages. Page one presents the rhythm strip, page two presents lead II, page three presents all limb leads, page four presents the precordial leads and the last page presents the full 12-lead ECG. Each page displays a prompt and a series of questions that require input before the reader can ‘progress’ to the next page.Results: When comparing preliminary results with meta-analysis from studies in ECG interpretation competency [1], using Chi-square test (p-value <0.01), the IPI system has improved interpretation accuracy from 40% to 57%. Conclusion: A new algorithmic model has been proposed to aid ECG interpretation where interpreters systematically and sequentially interpret the 12-lead ECG as a series of sub-tasks.

KW - ECG

KW - Health informatics

KW - decision support

M3 - Conference contribution

BT - Unknown Host Publication

ER -