ArticleCJEM2024
Safety and accuracy of the computer interpretation of normal ECGs at triage.
Article in CJEM, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- What is the gold standard for ECG interpretation: computer, cardiologist, or patient outcome?CJEM · 2025Article
- Artificial Intelligence Detection of Occlusive Myocardial Infarction from Electrocardiograms Interpreted as "Normal" by Conventional Algorithms.Journal of personalized medicine · 2025Article
- Thousands of critical interruptions.CJEM · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundECGs performed at ED triage are mandatorily assessed by an emergency physician contributing to task interruptions, decreased quality of care and increased error risk. Recent literature suggests that a triage ECG interpreted as normal by the ECG machine software correlates with benign interpretation from attending cardiologists. Ambiguity persists regarding the safety of the normal computerized ECG interpretation and whether real-time physician review is needed.
methodsIn this prospective cohort study, we evaluated the GE Marquette 12SL ECG software's clinical accuracy for normal triage ECGs. We compared machine interpretation, ED physicians' real-time interpretation and management as well as cardiologists systematic but delayed review of the ECGs to establish diagnostic accuracy and safety of a normal software interpretation. Additional data were collected from the emergency department patient tracking system and charts to determine patient outcomes when machine normal interpretation differed from ED physicians and cardiologists' analysis.
resultsBetween November 16th 2020 and November 19th 2021, we collected 1220 machine-normal ECGs performed at Charles-Le Moyne Hospital ED triage. 1051 ECGs were eligible for inclusion. ED physicians agreed with the machine for 1028 normal diagnoses (97.8% IC (0.95): 96.7-98.5) and cardiologists agreed with the machine for 1037 ECGs (98.7% IC (0.95) 97.8-99.2). Relevant changes in ED management were recorded in three patients (0.29% IC (0.95): 0.1-0.8) whose ECGs were read as normal by the software: two emergent referrals to the catheterization lab and one emergent transfer to the resuscitation bay with next day coronarography.
conclusionA normal ECG interpretation from the GE Marquette 12SL ECG software at ED triage has a very high accuracy and a very low probability of clinically relevant change in patient outcome and ED trajectory.
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Registered trials
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