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NOVOTNÝ, Tomáš, Raymond BOND, Irena ANDRŠOVÁ, Lumír KOC, Martina ŠIŠÁKOVÁ, Dewar FINLAY, Daniel GULDENRING, Jindřich ŠPINAR and Marek MALIK. The role of computerized diagnostic proposals in the interpretation of the 12-lead electrocardiogram by cardiology and non-cardiology fellows. International Journal of Medical Informatics. Clare: Elsevier Ireland Ltd., 2017, vol. 101, MAY 2017, p. 85-92. ISSN 1386-5056. Available from: https://dx.doi.org/10.1016/j.ijmedinf.2017.02.007.

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TY  - JOUR
ID  - 1379601
AU  - Novotný, Tomáš - Bond, Raymond - Andršová, Irena - Koc, Lumír - Šišáková, Martina - Finlay, Dewar - Guldenring, Daniel - Špinar, Jindřich - Malik, Marek
PY  - 2017
TI  - The role of computerized diagnostic proposals in the interpretation of the 12-lead electrocardiogram by cardiology and non-cardiology fellows
JF  - International Journal of Medical Informatics
VL  - 101
IS  - MAY 2017
SP  - 85-92
EP  - 85-92
PB  - Elsevier Ireland Ltd.
SN  - 13865056
KW  - Computerized diagnostic proposals
KW  - Decision making
KW  - Electrocardiogram interpretations
N2  - Introduction Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. Materials and methods A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Results Availability of diagnostic proposals significantly increased the diagnostic accuracy (p < 0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho 2, p < 0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR = 10.87) or multiple proposals (OR = 4.43). Conclusion Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters.
ER  -

Basic information
Original name	The role of computerized diagnostic proposals in the interpretation of the 12-lead electrocardiogram by cardiology and non-cardiology fellows
Authors	NOVOTNÝ, Tomáš (203 Czech Republic, guarantor, belonging to the institution), Raymond BOND (826 United Kingdom of Great Britain and Northern Ireland), Irena ANDRŠOVÁ (203 Czech Republic, belonging to the institution), Lumír KOC (203 Czech Republic, belonging to the institution), Martina ŠIŠÁKOVÁ (203 Czech Republic, belonging to the institution), Dewar FINLAY (826 United Kingdom of Great Britain and Northern Ireland), Daniel GULDENRING (826 United Kingdom of Great Britain and Northern Ireland), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution) and Marek MALIK (826 United Kingdom of Great Britain and Northern Ireland).
Edition	International Journal of Medical Informatics, Clare, Elsevier Ireland Ltd. 2017, 1386-5056.

Other information
Original language	English
Type of outcome	Article in a journal
Field of Study	10201 Computer sciences, information science, bioinformatics
Country of publisher	Ireland
Confidentiality degree	is not subject to a state or trade secret
Impact factor	Impact factor: 2.957
RIV identification code	RIV/00216224:14110/17:00096598
Organization unit	Faculty of Medicine
Doi	http://dx.doi.org/10.1016/j.ijmedinf.2017.02.007
UT WoS	000400437200011
Keywords in English	Computerized diagnostic proposals; Decision making; Electrocardiogram interpretations
Tags	EL OK
Tags	International impact, Reviewed
Changed by	Changed by: Soňa Böhmová, učo 232884. Changed: 20/3/2018 18:27.

Abstract
Introduction Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. Materials and methods A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Results Availability of diagnostic proposals significantly increased the diagnostic accuracy (p < 0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho 2, p < 0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR = 10.87) or multiple proposals (OR = 4.43). Conclusion Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters.

Abstract

Introduction Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. Materials and methods A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Results Availability of diagnostic proposals significantly increased the diagnostic accuracy (p < 0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho 2, p < 0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR = 10.87) or multiple proposals (OR = 4.43). Conclusion Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters.