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

Carolina A Escudero, Shubhayan Sanatani, Kenny K Wong, Christina G Templeton
Paediatrics & Child Health 2014, 19 (2): 77-83

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.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"