Impact of a clinical scenario on accuracy of electrocardiogram interpretation
Impact of a clinical scenario on accuracy of electrocardiogram interpretation
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DOI：
10.1046/j.1525-1497.1999.00298.x
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发表时间：
1999-02-01
影响因子：
5.7
通讯作者：
Brooks, LR
中科院分区：
文献类型：
--
作者：
Hatala, R;Norman, GR;Brooks, LR
为了研究临床病史对不同专业水平医生心电图（ECG）解读技能的影响，我们将30名最后一年的医学生、15名第二年的内科住院医师和15名大学附属教学医院的大学心脏病专家随机分配到ECG测试包中。所有参与者均解读了同一组10个ECG。每个ECG都伴随有提示正确ECG诊断的简短临床病史，或最合理的替代诊断，或无病史。与无病史相比，提供正确病史可使准确性提高4%至12%，这取决于培训水平。相反，与没有病史相比，误导性病史会使心脏病专家的准确性降低5%，居民降低25%，学生降低19%。临床病史也影响参与者列出符合正确诊断的ECG特征和符合替代诊断的特征的频率（所有p值
To examine the effect of clinical history on the electrocardiogram (ECG) interpretation skills of physicians with different levels of expertise, we randomly allocated to an ECG test package 30 final-year medical students, 15 second-year internal medicine residents, and 15 university cardiologists at university-affiliated teaching hospitals. All participants interpreted the same set of 10 ECGs. Each ECG was accompanied by a brief clinical history suggestive of the correct ECG diagnosis, or the most plausible alternative diagnosis, or no history, Provision of a correct history improved accuracy by 4% to 12% compared with no history, depending on level of training. Conversely, a misleading history compared with no history reduced accuracy by 5% for cardiologists, 25% for residents, and 19% for students. Clinical history also affected the participants' frequencies of listing ECG features consistent with the correct diagnosis and features consistent with the alternative diagnosis (all p values