Interpretations of and management actions following ECGs in programmatic cardiovascular care in primary care: A retrospective dossier study

Abstract

Background The usefulness of routine electrocardiograms (ECGs) in cardiovascular risk management (CVRM) and diabetes care is doubted. Objectives To assess the performance of general practitioners (GPs) in embedding ECGs in CVRM and diabetes care. Methods We collected 852 ECGs recorded by 20 GPs (12 practices) in the context of CVRM and diabetes care. Of all abnormal (n = 265) and a sample of the normal (n = 35) ECGs, data on the indications, interpretations and management actions were extracted from the corresponding medical records. An expert panel consisting of one cardiologist and one expert GP reviewed these 300 ECG cases. Results GPs found new abnormalities in 13.0% of all 852 ECGs (12.0% in routinely recorded ECGs versus 24.3% in ECGs performed for a specific indication). Management actions followed more often after ECGs performed for specific indications (17.6%) than after routine ECGs (6.0%). The expert panel agreed with the GPs' interpretations in 67% of the 300 assessed cases. Most often misinterpreted relevant ECG abnormalities were previous myocardial infarction, R-wave abnormalities and typical/atypical ST-segment and T-wave (ST-T) abnormalities. Agreement on patient management between GP and expert panel was 74%. Dis-Electronic supplementary material The online version of this article (

Diagnosis and management of arrhythmias in dogs: A cross‐sectional online survey among Flemish veterinary practitioners

“…Insufficient ECG interpreting skills was a common answer to several questions in this survey. Previous studies in human medicine have revealed moderate ECG interpreting competences among medical personal 8–10 . In one study, about one‐third of general practitioners and nurses felt very to fairly uncomfortable interpreting a routine ECG 9 .…”

“…Previous studies in human medicine have revealed moderate ECG interpreting competences among medical personal. 8 , 9 , 10 In one study, about one‐third of general practitioners and nurses felt very to fairly uncomfortable interpreting a routine ECG. 9 Despite the fact that our study was not aimed at scoring ECG competences across veterinarians, our findings suggest there should be further investigation.…”

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