Trial reportBMC emergency medicine2026
Electrocardiogram sonification accelerates detection of ST elevation myocardial infarction compared to analysis based solely on visual display: a randomized controlled simulation study with medical students.
Trial report in BMC emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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7 authors.
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Abstract
purposeA 12 lead electrocardiogram (ECG) is the standard diagnostic method for the detection of an acute coronary syndrome, as it is also used in emergency medical services. A novel sonification method can convert an important part of the ECG signal into an acoustic signal: The ST segment sonification is particularly useful for the detection of transient ST elevations in patients with suspicion of acute coronary syndrome. A quick and accurate detection of transient ECG changes of the ST segment is prerequisite for proper treatment, thus having immediate therapeutic consequences.
methodsAs part of an emergency training program, a cohort of [Formula: see text] medical students was recruited to participate in a two-part study. Some of them, namely [Formula: see text] of the total 44 subjects, participated in a second part of the study, an RCT, which we report on here. The diagnostic accuracy recently estimated in a classification study involving all 44 subjects with regard to acoustically presented ECG sequences of varying degrees of severity of ST-elevation myocardial infarction forms the background for the RCT described here. The [Formula: see text] subjects who participated in the RCT were randomly assigned in two-person teams to either an intervention ([Formula: see text] teams of two) or a control ([Formula: see text] teams of two) arm, respectively, whereby all teams, except for one dropout due to a technical failure in the intervention arm, went through an emergency simulation where they had to detect an emerging ST elevation myocardial infarction. The intervention group was endowed with a sonification-assisted equipment whereas the control group used standard visual-based ECG diagnosis only.
resultsAn adjusted multivariable regression yielded a statistically significant reduction for the intervention group of the delay time from starting a first ECG to the correct diagnosis by 163 seconds ([Formula: see text]) corresponding to [Formula: see text] of the average delay time in the control group. A subgroup analysis within the intervention arm revealed a notable impact of the attitude toward sonification on delay time between the second ECG and diagnosis. Specifically, increasing disagreement with statement “I conceived the sound of the sonification as pleasant” counterintuitively reduced the delay, whereas an increasing disagreement with “sonification was helpful in making the diagnosis” increased the delay.
conclusionThe sonification of ECG proved to be significantly superior as an accompanying diagnostic measure in emergency medical services in cases of suspected acute coronary syndrome in a simulated emergency scenario in terms of a proof-of-concept. The established dependence on individual attitudes towards sonification serves to further optimize sonification aesthetics and implementation with a focus on greater alertness and the reduction of stress-induced destraction or alarm fatigue.
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