Accuracy of blinded clinician interpretation of single-lead smartphone electrocardiograms and a proposed clinical workflow - 17/12/18

Doi : 10.1016/j.ahj.2018.08.001

Anoop N Koshy, MBBS ^a,^b,^{^{1
Authors A. N. K. and J. K. S. are co-first authors.}}, Jithin K Sajeev, MBChB ^a,^{^{1
Authors A. N. K. and J. K. S. are co-first authors.}}, Kazuaki Negishi, MD, PhD ^c,^e, Michael C Wong, MBBS, PhD ^a, Christopher B Pham, MBBS ^a, Sumudu P Cooray, MBBS ^a, Yeganeh Khavar, MBBS ^a, Louise Roberts, PhD ^a, Jennifer C Cooke, MBBS ^a, Andrew W Teh, MBBS, PhD ^a,^b,^d
^a Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia
^b The University of Melbourne Clinical School, Austin Health Department of Cardiology, Melbourne, Victoria, Australia
^c Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
^d Reprint requests: Andrew W Teh MBBS, PhD, Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, 5 Arnold St, Box Hill 3128; Melbourne, Victoria, Australia.
^e Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Australia

Abstract

Despite the appeal of smartphone-based electrocardiograms (ECGs) for arrhythmia screening, a paucity of data exists on the accuracy of primary care physicians' and cardiologists' interpretation of tracings compared with the device's automated diagnosis. Using 408 ECGs in 51 patients, we demonstrate a variable accuracy in clinician interpretation of smartphone-based ECGs, with only cardiologists demonstrating satisfactory agreement when referenced against a 12-lead ECG. Combining the device automated diagnostic algorithm with cardiologist interpretation of only uninterpretable traces yielded excellent results and provides an efficient, cost-effective workflow for the utilization of a smartphone-based ECG in clinical practice.

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Workflow incorporating AHM and clinician interpretation

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	Clinical trial registration: Australian & New Zealand Clinical Trials Registry (ACTRN:12616991374459).
	Funding: Dr Koshy is supported by the National Health and Medical Research Council of Australia and National Heart Foundation Scholarship. Dr Negishi is supported by the National Heart Foundation Future Leader Fellow Scholarship. Dr Teh is supported by an Early Career Fellowship from the National Health and Medical Research Council of Australia.
	This work was supported by the Eastern Health Foundation Research Grant (EHFRG2017_029). The sponsor had no role in study design, collection, analysis, and interpretation of data and in the decision to submit the article for publication.
	Declarations of interest: none.

Esportazione

Vol 205

P. 149-153 - Novembre 2018 Ritorno al numero

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Accuracy of blinded clinician interpretation of single-lead smartphone electrocardiograms and a proposed clinical workflow - 17/12/18

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