Do computer generated ECG reports improve interpretation by accident and emergency senior house officers?
OBJECTIVE
To determine whether access to a computer generated electrocardiogram (ECG) report can reduce errors of interpretation by senior house officers (SHOs) in an accident and emergency department.


METHODS
Ten SHOs were asked to interpret 50 ECGs each: 25 with computer generated reports, 25 without. Their answers, and the computer generated reports, were compared with a "gold standard" produced by two experienced clinicians. The primary outcome measure was the proportion of major errors of interpretation.


RESULTS
The computer reading system made two major errors (4%, 95% confidence interval (CI) 1.1% to 13.5%) compared with the gold standard. Access to the computer report did not significantly reduce major errors among SHOs (46 (18.4%) with report v 56 (22.4%) without, odds ratio 0.64, 95% CI 0.36% to 1.14%, p=0.13) or improve the proportion completely correct (104 (41.6%) with report v 91 (36.4%) without, odds ratio 1.43, 95% CI 0.88 to 2.33, p=0.15).


CONCLUSIONS
SHOs have a high error rate when interpreting ECGs, which is not significantly reduced by access to a computer generated report. Junior doctors should continue to seek expert senior help when they have to interpret a difficult ECG.
Goodacre
S
S
Department of Accident & Emergency Medicine, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. S.Goodacre@sheffield.ac.uk
Webster
A
A
Morris
F
F
D002983:Clinical Competence; D016001:Confidence Intervals; D003936:Diagnosis, Computer-Assisted; D003951:Diagnostic Errors / Q000517:prevention & control*; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000592:standards*; D004739:England; D006801:Humans; D008505:Medical Staff, Hospital / Q000592:standards; D012815:Signal Processing, Computer-Assisted