Using computerised interactive response technology to assess electrocardiographers and for aggregating diagnoses

Aaron Peace; Adesh Ramsewak; Andrew Cairns; Dewar Finlay; Daniel Guldenring; Gari Clifford; Raymond Bond

doi:10.1016/j.jelectrocard.2015.08.003

Using computerised interactive response technology to assess electrocardiographers and for aggregating diagnoses

J Electrocardiol. 2015 Nov-Dec;48(6):995-9. doi: 10.1016/j.jelectrocard.2015.08.003. Epub 2015 Aug 4.

Authors

Aaron Peace¹, Adesh Ramsewak², Andrew Cairns³, Dewar Finlay⁴, Daniel Guldenring⁴, Gari Clifford⁵, Raymond Bond³

Affiliations

¹ Department of Cardiology, Altnagelvin Hospital, Western Health and Social Care Trust; Northern Ireland Centre for Stratified Medicine, CITRIC, University of Ulster. Electronic address: apeace@rcsi.ie.
² Department of Cardiology, Altnagelvin Hospital, Western Health and Social Care Trust.
³ Computer Science Research Institute, University of Ulster, Belfast.
⁴ School of Engineering, University of Ulster, Belfast.
⁵ School of Medicine, Emory University, US.

PMID: 26341646
DOI: 10.1016/j.jelectrocard.2015.08.003

Abstract

The 12-lead electrocardiogram (ECG) is a crucial diagnostic tool. However, the ideal method to assess competency in ECG interpretation remains unclear. We sought to evaluate whether keypad response technology provides a rapid, interactive way to assess ECG knowledge. 75 participants were enrolled [32 (43%) Primary Care Physicians, 24 (32%) Hospital Medical Staff and 19 (25%) Nurse Practitioners]. Nineteen ECGs with 4 possible answers were interpreted. Out of 1425 possible decisions 1054 (73.9%) responses were made. Only 570/1425 (40%) of the responses were correct. Diagnostic accuracy varied (0% to 78%, mean 42%±21%) across the entire cohort. Participation was high, (median 83%, IQR 50%-100%). Hospital Medical Staff had significantly higher diagnostic accuracy than nurse practitioners (50±20% vs. 38±19%, p=0.04) and Primary Care Physicians (50±20% vs. 40±21%, p=0.07) although not significant. Interactive voting systems can be rapidly and successfully used to assess ECG interpretation. Further education is necessary to improve diagnostic accuracy.

Keywords: Diagnostic accuracy; ECG; Interactive response technology.

MeSH terms

Algorithms
Arrhythmias, Cardiac / diagnosis*
Clinical Competence / statistics & numerical data*
Electrocardiography / statistics & numerical data*
Humans
Ireland
Task Performance and Analysis*
User-Computer Interface*
Work Performance / classification
Work Performance / statistics & numerical data*