Accuracy of blinded clinician interpretation of single-lead smartphone electrocardiograms and a proposed clinical workflow

Anoop N Koshy; Jithin K Sajeev; Kazuaki Negishi; Michael C Wong; Christopher B Pham; Sumudu P Cooray; Yeganeh Khavar; Louise Roberts; Jennifer C Cooke; Andrew W Teh

doi:10.1016/j.ahj.2018.08.001

Accuracy of blinded clinician interpretation of single-lead smartphone electrocardiograms and a proposed clinical workflow

Am Heart J. 2018 Nov:205:149-153. doi: 10.1016/j.ahj.2018.08.001. Epub 2018 Aug 23.

Affiliations

¹ Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia; The University of Melbourne Clinical School, Austin Health Department of Cardiology, Melbourne, Victoria, Australia.
² Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia.
³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Australia.
⁴ Monash University, Eastern Health Clinical School, Department of Cardiology, Box Hill Hospital, Melbourne, Victoria, Australia; The University of Melbourne Clinical School, Austin Health Department of Cardiology, Melbourne, Victoria, Australia; 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.. Electronic address: [email protected].

PMID: 30195576
DOI: 10.1016/j.ahj.2018.08.001

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.

Publication types

Letter
Research Support, Non-U.S. Gov't

MeSH terms

Arrhythmias, Cardiac / diagnosis*
Cardiologists / standards*
Clinical Competence*
Electrocardiography / methods*
Humans
Prospective Studies
ROC Curve
Smartphone*
Telemedicine / methods*

Associated data

ANZCTR/ACTRN12616991374459