Do computer generated ECG reports improve interpretation by accident and emergency senior house officers?
S Goodacre, A Webster, F Morris
Department of
Accident & Emergency Medicine, Northern General Hospital, Herries Road,
Sheffield S5 7AU, UK
Correspondence to: Dr Goodacre S.Goodacre{at}sheffield.ac.uk
Submitted 29 August
2000;
Accepted 23 January 2001
OBJECTIVES
To determine whether
access to a computer generated electrocardiogram (ECG) report can
reduce errors of interpretation by senior house officers (SHOs) in an
accident and emergency department.
METHODSTen SHOs were asked to
interpret 50 ECGs each: 25 with computer generated reports, 25 without.
Their answers, and the computer generated reports, were compared with a
"gold standard" produced by two experienced clinicians. The primary
outcome measure was the proportion of major errors of interpretation.
RESULTSThe computer reading system
made two major errors (4%, 95% confidence interval (CI) 1.1% to
13.5%) compared with the gold standard. Access to the computer report
did not significantly reduce major errors among SHOs (46 (18.4%) with
report v 56 (22.4%) without, odds ratio
0.64, 95% CI 0.36% to 1.14%, p=0.13) or improve the proportion
completely correct (104 (41.6%) with report
v 91 (36.4%) without, odds ratio 1.43, 95%
CI 0.88 to 2.33, p=0.15).
CONCLUSIONSSHOs have a high error
rate when interpreting ECGs, which is not significantly reduced by
access to a computer generated report. Junior doctors should continue
to seek expert senior help when they have to interpret a difficult ECG.
Keywords: electrocardiogram; computer reading systems; accident and emergency
© 2001 by The Fellowship of Postgraduate Medicine
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