The Role of Computerized Diagnostic Proposals in the Interpretation of the 12-lead Electrocardiogram by Cardiology and Non-Cardiology Fellows

Tomas Novotny, Raymond Bond, Irena Andrsova, Lumir Koc, Martina Sisakova, Dewar Finlay, Daniel Guldenring, Jindrich Spinar, Marek Malik

Research output: Contribution to journalArticle

9 Citations (Scopus)
34 Downloads (Pure)

Abstract

Introduction: Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. Materials and methods: A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Results: Availability of diagnostic proposals significantly increased the diagnostic accuracy (p <0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho ≈ 2, p
Original languageEnglish
Pages (from-to)85-92
JournalInternational Journal of Medical Informatics
Volume101
Early online date14 Feb 2017
DOIs
Publication statusPublished - May 2017

Keywords

  • computerized diagnostic proposals
  • decision making
  • electrocardiogram interpretation
  • ECG
  • cardiology
  • decision support systems

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