Dataset Information

Competence of general practitioners in requesting and interpreting ECGs - a case vignette study.

ABSTRACT:

Background

Performing electrocardiography is common in general practice, but the quality of indication setting and diagnostic accuracy have been disputed.

Objectives

To assess the competence of general practitioners (GPs) in their decision-making process with regard to recording and interpreting an electrocardiogram (ECG) and evaluating the relevance of the result for management.

Methods

An online case vignette survey was performed among GPs and cardiologists (in 2015). Nine cases describing situations for which Dutch clinical guidelines recommend or advise against recording an ECG were presented. In each case, the participant had to make choices on recording an ECG, interpreting it, and using the result in a management decision. The reference standard for each ECG diagnosis was set by the expert author team.

Results

Fifty GPs who interpret ECGs themselves, eight GPs who do not and 12 cardiologists completed the survey. Adherence to guidelines recommending an ECG was high for suspected atrial fibrillation, suspected arrhythmia present during consultation, including bradycardia, but much lower for progressive heart failure and stable angina. Diagnostic accuracy of GPs was best in atrial fibrillation (96%), sick sinus syndrome (85%) and old myocardial infarction (82%), but poor in left anterior fascicular block (16%) and incomplete right bundle branch block (10%). GPs often acknowledged the low relevance of the results of a non-indicated ECG.

Conclusion

GPs do not fully adhere to Dutch cardiovascular guidelines on indications for recording ECGs. Diagnostic accuracy was high for atrial fibrillation, sick sinus syndrome and old myocardial infarction and poor for left anterior fascicular block and incomplete right bundle branch block.

SUBMITTER: Compiet SAM

PROVIDER: S-EPMC6046661 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Competence of general practitioners in requesting and interpreting ECGs - a case vignette study.

Compiet S A M SAM Willemsen R T A RTA Konings K T S KTS Stoffers H E J H HEJH

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation 20180801 7-8

<h4>Background</h4>Performing electrocardiography is common in general practice, but the quality of indication setting and diagnostic accuracy have been disputed.<h4>Objectives</h4>To assess the competence of general practitioners (GPs) in their decision-making process with regard to recording and interpreting an electrocardiogram (ECG) and evaluating the relevance of the result for management.<h4>Methods</h4>An online case vignette survey was performed among GPs and cardiologists (in 2015). Nin ...[more]

PMID: 29882041

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Dataset Information

Competence of general practitioners in requesting and interpreting ECGs - a case vignette study.

Background

Objectives

Methods

Results

Conclusion

Publications

Competence of general practitioners in requesting and interpreting ECGs - a case vignette study.

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