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Standardised criteria improve accuracy of ECG interpretation in competitive athletes: a randomised controlled trial.

Abstract：

BACKGROUND:Screening to prevent sudden cardiac death remains a contentious topic in sport and exercise medicine. The aim of this study was to assess whether the use of a standardised criteria tool improves the accuracy of ECG interpretation by physicians screening athletes. METHODS:Design: Randomised control trial. Study Population: General practitioners with an interest in sports medicine, sports physicians, sports medicine registrars and cardiologists from Australia and New Zealand were eligible to participate. Outcome Measures: Accuracy, sensitivity, specificity and false-positive rates of screening ECG interpretation of athletes. Intervention: A two-page standardised ECG criteria tool was provided to intervention participants. Control participants undertook 'usual' interpretation. RESULTS:62 physicians, with a mean duration of practice of 16 years, were randomised to intervention and control. 10 baseline and 30 postrandomisation athlete ECGs were interpreted by the participants. Intervention participants were more likely to be correct: OR 1.72 (95% CI 1.31 to 2.27, p<0.001). Correct ECG interpretation was higher in the intervention group, 88.4% (95% CI 85.7% to 91.2%), than in the control group, 82.2% (95% CI 78.8% to 85.5%; p=0.005). Sensitivity was 95% in the intervention group and 92% in the control group (p=0.4), with specificity of 86% and 78%, respectively (p=0.006). There were 36% fewer false positives in the intervention group (p=0.006). CONCLUSIONS:ECG interpretation in athletes can be improved by using a standardised ECG criteria tool. Use of the tool results in lower false-positive rates; this may have implications for screening recommendations. TRIAL REGISTRATION NUMBER:ACTRN12612000641897.

journal_name

Br J Sports Med

journal_title

British journal of sports medicine

authors

Exeter DJ,Elley CR,Fulcher ML,Lee AC,Drezner JA,Asif IM

doi

10.1136/bjsports-2013-093360

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

1167-71

issue

15

eissn

0306-3674

issn

1473-0480

pii

bjsports-2013-093360

journal_volume

48

pub_type

杂志文章,随机对照试验

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