Accuracy of general practitioners' readings of ECG in primary care.

Autor: Santos, Paulo, Pessanha, Paulo, Viana, Manuel, Campelo, Manuel, Nunes, José, Hespanhol, Alberto, Macedo, Filipe, Couto, Luciana
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Zdroj: Central European Journal of Medicine; Jun2014, Vol. 9 Issue 3, p431-436, 6p
Abstrakt: Background: 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. Aim: To evaluate accuracy of ECG readings done by GPs by comparison with those done by a cardiologist as the gold standard. Methods: 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. Results: 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%. Conclusion: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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