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

Novotny, Tomas, Bond, Raymond, Andrsova, Irena, Koc, Lumir, Sisakova, Martina, Finlay, Dewar, Guldenring, Daniel, Spinar, Jindrich and Malik, Marek (2017) The Role of Computerized Diagnostic Proposals in the Interpretation of the 12-lead Electrocardiogram by Cardiology and Non-Cardiology Fellows. International Journal of Medical Informatics, 101 . pp. 85-92. [Journal article]

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URL: http://www.sciencedirect.com/science/article/pii/S1386505617300382

DOI: 10.1016/j.ijmedinf.2017.02.007


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<0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR = 10.87) or multiple proposals (OR = 4.43). Conclusion: Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters.

Item Type:Journal article
Keywords:computerized diagnostic proposals, decision making, electrocardiogram interpretation, ECG, cardiology, decision support systems
Faculties and Schools:Faculty of Computing & Engineering
Faculty of Computing & Engineering > School of Computing and Mathematics
Faculty of Computing & Engineering > School of Engineering
Research Institutes and Groups:Engineering Research Institute
Engineering Research Institute > Nanotechnology & Integrated BioEngineering Centre (NIBEC)
Computer Science Research Institute > Smart Environments
Computer Science Research Institute
ID Code:37003
Deposited By: Dr Raymond Bond
Deposited On:21 Feb 2017 14:51
Last Modified:24 Feb 2017 15:04

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