Accuracy of Electro Cardiogram (ECG) Interpretation and need for ECG Audit in Emergency Department, A prospective observational study from a tertiary care teaching hospital

Authors

  • Ravindra Gade NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District,AP, INDIA – 522 503
  • John Satish Rudrapogu NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP, INDIA– 522 503
  • Monika E Florence Tadi NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP, INDIA– 522 503
  • Vijaya Kumar Vasa NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP,INDIA – 522 503
  • Ponnuru Venkata Ananda Deepika NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP,INDIA – 522 503
  • Pujita Nalagatla MangalagiriMandal,Guntur District, AP, INDIA – 522 503
  • Nikhit Guntupalli MangalagiriMandal,Guntur District, AP, INDIA – 522 503

DOI:

https://doi.org/10.21276/apjhs.2015.2.1.30

Keywords:

Accuracy, ECG, Emergency Department, Cardiac Emergencies

Abstract

In spite of much recent advancement, 12 lead electro cardiogram (ECG) is still the most relied upon tool for diagnosis of cardiac emergencies in the emergency departments, especially in resource poor settings. Studies on accuracy of ECG interpretations, their likely impact in the emergency departments are scarce from India. Objective:To assess the accuracy of the ECG interpretation by CMO/resident doctors and emergency physicians, in emergency department of a tertiary care teaching hospital in south India. Methodology:The study was a prospective observational study conducted in the emergency medicine department of tertiary care teaching hospital. ECG interpretations of CMO/resident doctor and emergency physicians are compared against the blinded, gold standard interpretation by a cardiologist panel. Results:A total of 2857 ECGs of the patients presenting with chest pain were analyzed. The overall concordance as assessed by mean pair agreement index (MPAI) was higher for emergency physician (MPAI=83.75%, Kappa statistic =0.50), compared to CMO/resident doctor (MPAI=75.95%, Kappa statistic =0.48). The concordance rate for abnormal ECG, as assessed by sensitivity of was only 67.2% for CMO/ resident doctor and was 78.3% for emergency physician. The concordance rate for normal ECGs, as assessed by specificity was 81.5% and 87.2% respectively for both the groups. Conclusions:ECG interpretation skills for both normal and abnormal ECGs are better in emergency physicians, compared to CMO/resident doctors and are better for normal ECGs, compared to abnormal ECGs. Many life threatening emergencies, which need immediate intervention, are being missed.

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Author Biographies

Ravindra Gade, NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District,AP, INDIA – 522 503

Department of Emergency Medicine; 

John Satish Rudrapogu, NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP, INDIA– 522 503

Department of Cardiology;

Monika E Florence Tadi, NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP, INDIA– 522 503

Department of Cardiology; 

Vijaya Kumar Vasa, NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP,INDIA – 522 503

Department of General Medicine; 

Ponnuru Venkata Ananda Deepika, NRI Medical College,Chinakakani, MangalagiriMandal,Guntur District, AP,INDIA – 522 503

Department of General Medicine;

Pujita Nalagatla, MangalagiriMandal,Guntur District, AP, INDIA – 522 503

Student NRI Medical College,Chinakakani, 

Nikhit Guntupalli, MangalagiriMandal,Guntur District, AP, INDIA – 522 503

Student NRI Medical College,Chinakakani, 

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Published

2015-03-30

How to Cite

Ravindra Gade, John Satish Rudrapogu, Monika E Florence Tadi, Vijaya Kumar Vasa, Ponnuru Venkata Ananda Deepika, Pujita Nalagatla, & Nikhit Guntupalli. (2015). Accuracy of Electro Cardiogram (ECG) Interpretation and need for ECG Audit in Emergency Department, A prospective observational study from a tertiary care teaching hospital . Asian Pacific Journal of Health Sciences, 2(1), 173–178. https://doi.org/10.21276/apjhs.2015.2.1.30