Electrocardiogram interpretation by Canadian general paediatricians: Examining practice, accuracy and confidence.

Abstract:

BACKGROUND:Paediatric electrocardiograms (ECGs) are ordered and interpreted by general paediatricians; however, no previous studies have evaluated the accuracy of their ECG interpretations. OBJECTIVE:To determine general paediatricians' practice and opinions regarding ECG use, accuracy of their interpretation of paediatric ECGs, and the relationship between accuracy and self-perceived confidence. METHODS:In the present cross-sectional study, Canadian general paediatricians were asked to complete a questionnaire and interpret 18 paediatric ECGs. The questionnaire assessed characteristics of ECG use, self-perceived confidence and opinions regarding ECG use in general paediatric practice. For the ECGs provided, respondents were asked whether the ECG was normal or abnormal, what abnormality the ECG demonstrated and how confident they were in this interpretation. RESULTS:ECG interpretation was performed by 124 general paediatricians. General paediatricians frequently use ECGs in their practice and regard this investigation as useful in patient assessment. The mean (± SD) accuracy of identifying ECGs as normal or abnormal, and identifying the specific abnormality was 80±12% and 56±20%, respectively. The sensitivity and specificity of identifying abnormal ECGs were 80% (95% CI 78% to 82%) and 79% (95% CI 75% to 83%), respectively. Correct ECG interpretation for isolated rhythm disturbances (73%) was significantly better than for abnormalities in axis (25%), chamber hypertrophy (41%) and ECG intervals (49%) (P<0.001). Overall confidence in ECG interpretation correlated with and was the only significant predictor of interpretation accuracy (r=0.396, P<0.001). CONCLUSION:General paediatricians were adept at detecting abnormal ECGs, but were less able to identify the abnormalities. Further education in ECG interpretation may be important for this population. HISTORIQUE:Ce sont des pédiatres généralistes qui demandent et interprètent les électrocardiogrammes (ECG) en pédiatrie, mais aucune étude n’a porté sur l’exactitude de leur interprétation. OBJECTIF:Déterminer la pratique et les avis des pédiatres généralistes en matière d’utilisation des ECG et de l’exactitude des ECG en pédiatrie et établir le lien entre la précision et l’autoperception de la confiance. MÉTHODOLOGIE:Dans la présente étude transversale, les pédiatres généralistes canadiens ont été invités à remplir un questionnaire et à interpréter 18 ECG en pédiatrie. Le questionnaire visait à évaluer les caractéristiques liées à l’utilisation des ECG, l’autoperception de la confiance et les avis relatifs à l’utilisation des ECG en pédiatrie générale. Les répondants étaient invités à préciser si les ECG four-nis étaient normaux ou anormaux, les anomalies démontrées et leur confiance quant à leur interprétation. RÉSULTATS:Cent vingt-quatre pédiatres généralistes ont interprété les ECG. Les pédiatres généralistes utilisent souvent les ECG dans leur pratique et les considèrent comme utiles dans l’évaluation des patients. L’exactitude moyenne dans l’identification des ECG comme normaux ou anormaux et dans la détermination de l’anomalie précise correspondait à 80±12 % et à 56±20 %, respectivement. La sensibilité et la spécificité de l’identification des ECG anormaux s’établissaient à 80 % (95 % IC 78 % à 82 %) et à 79 % (95 % IC 75 % à 83 %), respectivement. La bonne interprétation des ECG révélant des troubles isolés du rythme cardiaque (73 %) était considérablement plus élevée que celle des anomalies de l’axe (25 %), de l’hypertrophie ventriculaire (41 %) et des intervalles d’ECG (49 %) (P<0,001). Dans l’ensemble, la confiance à l’égard de l’interprétation des ECG était corrélée avec l’exactitude des interprétations et en était le seul prédicteur important (r=0,396, P<0,001). CONCLUSION:Les pédiatres généralistes décelaient bien les ECG anormaux, mais réussissaient moins bien à déterminer les anomalies exactes. Il serait peut-être important de leur fournir un perfectionnement dans l’interprétation des ECG.

journal_name

Paediatr Child Health

authors

Escudero CA,Sanatani S,Wong KK,Templeton CG

doi

10.1093/pch/19.2.77

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

77-83

issue

2

eissn

1205-7088

issn

1918-1485

journal_volume

19

pub_type

杂志文章
  • Choosing medications wisely: Is it time to address paediatric polypharmacy?

    abstract::There is a growing focus in the medical community on de-escalating medical treatments where appropriate; however, specific efforts to reduce medication burden in patients with polypharmacy has largely been targeted toward adult populations. Polypharmacy increases the risk of adverse drug reactions in children, and tha...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxy188

    authors: Bogler O,Roth D,Feinstein J,Strzelecki M,Seto W,Cohen E

    更新日期:2019-08-01 00:00:00

  • The breastfeeding paradox: Relevance for household food insecurity.

    abstract::Mitigating the harmful effects of adverse social conditions is critical to promoting optimal health and development throughout the life course. Many Canadians worry over food access or struggle with household food insecurity. Public policy positions breastfeeding as a step toward eradicating poverty. Breastfeeding ful...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxx067

    authors: Venu I,van den Heuvel M,Wong JP,Borkhoff CM,Moodie RG,Ford-Jones EL,Wong PD

    更新日期:2017-07-01 00:00:00

  • Performing bone marrow aspiration and biopsy in children: Recommended guidelines.

    abstract::Bone marrow aspiration (BMA) and bone marrow trephine biopsy are important procedures for the diagnosis of hematological malignancies and nonmalignant diseases in children. During BMA, bone marrow particles are obtained for analysis including microscopic morphologic evaluations and differential counts. During a trephi...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/13.6.499

    authors: Abla O,Friedman J,Doyle J

    更新日期:2008-07-01 00:00:00

  • Paediatrician human resource planning in Canada: A 10-year follow-up.

    abstract:BACKGROUND:Paediatrician human resource planning in Canada is currently a major concern. The optimal mix of physicians by type of practice and geographical distribution also remains controversial for many groups of physicians. OBJECTIVE:To compare 10-year trends (1987 to 1997) in paediatric practice with respect to ag...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/10.10.595

    authors: Seabrook JA,Cukiernik V,Matsui D,Speechley KN,Rieder MJ

    更新日期:2005-12-01 00:00:00

  • Has the Alberta daily physical activity initiative been successfully implemented in Calgary schools?

    abstract:INTRODUCTION:In September 2005, the Alberta government introduced the daily physical activity (DPA) initiative, which requires that students from grades 1 to 9 be physically active in school for a minimum of 30 min per day. OBJECTIVE:To obtain information on whether and how the DPA initiative has been implemented in C...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/15.7.e19

    authors: Kennedy CD,Cantell M,Dewey D

    更新日期:2010-09-01 00:00:00

  • Transfusion and risk of infection in Canada: Update 2012.

    abstract::Although multiple critical steps are taken to minimize the risk of infection from transfusion of blood or blood products in developed countries, this risk can never be entirely eliminated. In Canada, the risks of noninfectious transfusion reactions, such as transfusion-related acute lung injury and major allergic or a...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/17.10.e102

    authors: Macdonald NE,O'Brien SF,Delage G

    更新日期:2012-12-01 00:00:00

  • Where physicians look for information on drug prescribing for children.

    abstract:BACKGROUND:Despite the important role of drug therapy in children, there is often a lack of readily available information regarding the indications and dosing regimens for medications in paediatrics. OBJECTIVE:To collect data on where family physicians obtain this prescribing information. METHOD:A structured question...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/8.4.219

    authors: Matsui DM,Jardine ME,Steer E,Cukernik V,Rieder MJ

    更新日期:2003-04-01 00:00:00

  • Environmental risks to Canadian children travelling overseas.

    abstract::Canadian children and youth travelling overseas face numerous environmental risks, including trauma, extreme temperatures, sun exposure, high altitudes, environmental pollution, and a variety of bites, stings and envenomations. Because skilled emergency response is limited or nonexistent in places where serious illnes...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/5.7.387

    authors: Kuhn S,Davies HD

    更新日期:2000-10-01 00:00:00

  • Management of acute otitis media in children six months of age and older.

    abstract::Acute otitis media (AOM) continues to be a common infection in young children. Milder disease, usually due to viruses or less virulent bacteria, resolves equally quickly with or without antibiotics. A bulging tympanic membrane, especially if yellow or hemorrhagic, has a high sensitivity for AOM that is likely to be ba...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/21.1.39

    authors: Le Saux N,Robinson JL,Canadian Paediatric Society, Infectious Diseases and Immunization Committee.

    更新日期:2016-01-01 00:00:00

  • Day of discharge and hospital readmission rates within 30 days in children: A population-based study.

    abstract:BACKGROUND:Adults discharged from hospital on a Friday are more likely to be readmitted within 30 days than are adults discharged midweek. No study has examined readmission rates for children by day of discharge. OBJECTIVE:To determine the risk of readmission within 30 days by day of discharge in the paediatric popula...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/11.7.409

    authors: Beck CE,Khambalia A,Parkin PC,Raina P,Macarthur C

    更新日期:2006-09-01 00:00:00

  • Death of a child: Parental perception of grief intensity - End-of-life and bereavement care.

    abstract:OBJECTIVE:The death of a child is a tragedy resulting in family trauma and disorganization. The present study sought to evaluate the intensity of grief experienced by parents who have lost a child in the perinatal period (stillbirth, premature baby, term baby less than one month) and parents who have lost a child after...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/8.6.363

    authors: Michon B,Balkou S,Hivon R,Cyr C

    更新日期:2003-07-01 00:00:00

  • The use of antiviral drugs for influenza: Guidance for practitioners, 2012/2013; Paediatric summary.

    abstract::This practice point summarizes the use of antiviral drugs to manage influenza illness in children and youth for the 2012/2013 season. It excerpts a recently published, full-length update of Canadian recommendations for clinicians on the use of antiviral drugs for the prevention and treatment of influenza, with a focus...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:

    authors: Allen UD,Canadian Paediatric Society, Infectious Diseases and Immunization Committee.

    更新日期:2013-03-01 00:00:00

  • A longitudinal study of the physical growth and health of postinstitutionalized Romanian adoptees.

    abstract::In the present longitudinal study, the physical growth and health of 36 early-deprived postinstitutionalized Romanian orphans (ROs; 17 boys) adopted by Canadian families are documented. Data were collected for each child at three time points: at 11 months postadoption, at 4.5 years of age and at 10.5 years of age. Dat...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:

    authors: Le Mare L,Audet K

    更新日期:2006-02-01 00:00:00

  • Fever in the returning child traveller: Highlights for health care providers.

    abstract::Recreation, globalization, migration, and families visiting friends and relatives (VFRs) overseas have increased the frequency of international travel and potential exposures to tropical diseases. Young infected patients can present a diagnostic challenge to clinicians when they return to Canada, with significant cons...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxy138

    authors: Audcent T,Hunter A

    更新日期:2018-12-01 00:00:00

  • Promoting the strengths and resilience of an Indigenous community through photovoice.

    abstract::In the face of negative media attention, community members and Elders from the First Nation community of Maskwacis identified the importance of promoting community strengths and reframing perceptions of their community. Two research questions were addressed: (1) How do youth in Maskwacis view their community strengths...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxx178

    authors: Tremblay M,Baydala L,Littlechild R,Chiu E,Janzen T

    更新日期:2018-07-01 00:00:00

  • Lead toxicity with a new focus: Addressing low-level lead exposure in Canadian children.

    abstract::Although acute and subacute lead toxicity requiring active treatment is rare in Canada, paediatricians need to be aware of new evidence linking lower lead levels to neurodevelopmental deficits. Health Canada has identified potential exposures occurring prenatally, in infancy and during early childhood from food and wa...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxz080

    authors: Buka I,Hervouet-Zeiber C

    更新日期:2019-07-01 00:00:00

  • Canada's eight-component vaccine safety system: A primer for health care workers.

    abstract::Concerns about vaccine safety make some parents hesitant about immunization. Health care providers are pivotal in helping parents understand that Canada is a leader in vaccine safety. The present practice point provides an update on the eight components of Canada's vaccine safety system: (1) an evidence-based pre-lice...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxx102

    authors: MacDonald NE,Law BJ

    更新日期:2017-07-01 00:00:00

  • Home injury patterns in children: A comparison by hospital sites.

    abstract:BACKGROUND:Many intervention studies typically require data from several centres to ensure adequate power. The usual intention is to pool data after testing for heterogeneity. Sites that differ in sample characteristics may, on the one hand, complicate the assessment of the intervention, but on the other hand, they may...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/8.7.433

    authors: Bernard-Bonnin AC,Pless IB,Robitaille Y,Leblanc J,King WJ,Tenenbein M,Klassen TP

    更新日期:2003-09-01 00:00:00

  • Patterns of reporting by health care and nonhealth care professionals to child protection services in Canada.

    abstract:BACKGROUND:All Canadian jurisdictions require certain professionals to report suspected or observed child maltreatment. The present study examined the types of maltreatment, level of harm and child functioning issues (controlling for family socioeconomic status, age and sex of the child) reported by health care and non...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/15.8.e25

    authors: Tonmyr L,Li YA,Williams G,Scott D,Jack SM

    更新日期:2010-10-01 00:00:00

  • Zika virus: What does a physician caring for children in Canada need to know?

    abstract::Zika virus (ZIKV) was recently recognized to be teratogenic. The diagnosis of congenital ZIKV syndrome should be considered in children with unexplained microcephaly, intracranial calcifications, ventriculomegaly or major structural central nervous system abnormalities. Management is evolving but suggestions are provi...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxx012

    authors: Robinson JL

    更新日期:2017-03-01 00:00:00

  • Does decreasing the frequency of changing intravenous administration sets (>24 h) increase the incidence of sepsis in neonates receiving total parenteral nutrition?

    abstract:BACKGROUND:The optimal timing for changing intravenous (IV) administration sets that contain total parenteral nutrition (TPN), with and without lipids, in neonates remains unknown. OBJECTIVE:To determine whether decreasing the frequency of changing IV administration sets (>24 h versus every 24 h) in neonates increases...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章,评审

    doi:

    authors: Chirinian N,Shah V

    更新日期:2012-11-01 00:00:00

  • Cross-cultural communication: Tools for working with families and children.

    abstract::The ability to communicate effectively with patients and families is paramount for good patient care. This practice point reviews the importance of communicating effectively in cross-cultural encounters. The concept of cultural competence is introduced, along with the LEARN (Listen, Explain, Acknowledge, Recommend, Ne...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/pxx126

    authors: Ladha T,Zubairi M,Hunter A,Audcent T,Johnstone J

    更新日期:2018-02-01 00:00:00

  • Adolescent chronic pain and disability: A review of the current evidence in assessment and treatment.

    abstract::Adolescents who suffer from chronic pain also report complex syndrome-associated disability and distress that can detrimentally affect the quality of their lives and the lives of their family members. Over the past 10 years, there have been significant developments in both methods of assessment and in treatment progra...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/12.2.117

    authors: Eccleston C,Clinch J

    更新日期:2007-02-01 00:00:00

  • A review of current guidelines for the management of Helicobacter pylori infection in children and adolescents.

    abstract::Helicobacter pylori infection is acquired in childhood and plays a causative role in chronic gastritis, peptic ulcer disease and the development of gastric cancer. The present review focuses on recent advances in the management of H pylori infection in children and provides an update of current Canadian guidelines reg...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/9.10.709

    authors: Jones NL

    更新日期:2004-12-01 00:00:00

  • Autonomic instability in a dehydrated child on guanfacine: Case report and literature review.

    abstract::An 8-year-old girl on guanfacine extended-release (GXR) for attention-deficit/hyperactivity disorder presented with somnolence, bradycardia and hypotension during a heat wave. No overdose was suspected. She was admitted to the intensive care unit for monitoring and ongoing fluid resuscitation for hypotension. Electroc...

    journal_title:Paediatrics & child health

    pub_type:

    doi:10.1093/pch/pxx172

    authors: Roach-Fox E,Welisch E,Sarpal A

    更新日期:2018-04-01 00:00:00

  • Children with disabilities in low-income countries.

    abstract::Disability is a major public health concern worldwide and the situation for children with disabilities is even more serious. The present article will focus on the issue of children with disabilities in low-income countries. Approximately one-third of the world's disabled population is children and many of these disabl...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/10.5.269

    authors: Cameron DL,Nixon S,Parnes P,Pidsadny M

    更新日期:2005-05-01 00:00:00

  • Sexual knowledge of Canadian adolescents after completion of high school sexual education requirements.

    abstract:BACKGROUND:Formal sexual education is a mandatory component of the high school curriculum in most Canadian provinces. The present study was a preliminary assessment of sexual knowledge among a sample of Ontario adolescents who had completed their high school sexual education requirements. METHODS:A questionnaire, test...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:

    authors: Kumar MM,Lim R,Langford C,Seabrook JA,Speechley KN,Lynch T

    更新日期:2013-02-01 00:00:00

  • Residents as teachers in Canadian paediatric training programs: A survey of program director and resident perspectives.

    abstract:BACKGROUND:The importance of the teaching role of residents in medical education is increasingly being recognized. There are little data about how this role is perceived within training programs or how residents develop their teaching skills. The aims of the present study were to explore the perspectives of Canadian pa...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/13.8.675

    authors: Walton JM,Patel H

    更新日期:2008-10-01 00:00:00

  • Persistent neonatal hypoglycemia: Diagnosis and management.

    abstract::Maintenance of plasma glucose depends on a normal endocrine system, functional enzyme levels for glycogenolysis, gluconeogenesis and other processes, and there must be an adequate supply of endogenous fat, glycogen and substrates of gluconeogenesis. Neonatal hypoglycemia should be defined as serum glucose less than 2....

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:10.1093/pch/3.1.16

    authors: Marles SL,Casiro OG

    更新日期:1998-01-01 00:00:00

  • A survey of the 16 Canadian child and youth protection programs: A threadbare patchwork quilt.

    abstract:BACKGROUND:Child abuse and neglect (CAN) represents an international public health and societal problem, the extent and nature of which are inadequately understood. Child and youth protection programs (CYPPs), based in 16 Canadian paediatric academic health science centres, identify, manage, treat and prevent cases of ...

    journal_title:Paediatrics & child health

    pub_type: 杂志文章

    doi:

    authors: Bennett S,Plint AC,Mackay M

    更新日期:2007-03-01 00:00:00