The role of telecardiology in supporting the decision-making process of general practitioners during the management of patients with suspected cardiac events.
We studied the role of telecardiology in reducing unnecessary hospital admissions of patients with suspected life-threatening cardiac events (CEs), evaluated by general practitioners (GPs). Over one month, 456 consecutive patients (mean age 65 years, SD 19) complaining of typical (10%) or atypical (42%) chest pain, palpitations (19%), dyspnoea (19%) or syncope (10%) were enrolled. Before teleconsultation, the GPs recorded their own opinion (based on clinical evaluation only) about the presence of a CE. Following transmission of the electrocardiogram (ECG), this opinion was compared with that of the cardiologist. In total there was agreement between the GP and cardiologist about the presence of a CE in 316 of the patients (69%) and disagreement in 140 patients (31%). This represents a specificity and sensitivity of the GPs' diagnosis of 76% and 47%, respectively. For 84 of 134 patients judged as having a CE by the GP, telecardiology avoided hospitalization; on the other hand, telecardiology identified a CE in 56 of 322 patients judged as not having a CE by the GP. Telecardiology is a useful tool with which to reduce unnecessary hospitalizations in patients with suspected life-threatening CEs.
Molinari
G
G
Department of Cardiology, University of Genova, Genova, Italy. molinari@cardio.dimi.unige.it
Reboa
G
G
Frascio
M
M
Leoncini
M
M
Rolandi
A
A
Balzan
C
C
Barsotti
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003657:Decision Making; D005194:Family Practice; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000592:standards*; D012423:Rural Health; D012680:Sensitivity and Specificity