title: [Interobserver agreement on electrocardiographic diagnosis of left ventricular hypertrophy in hypertensive patients in Andalusia. PREHVIA study].
abstract: OBJECTIVE
  To assess the agreement between Primary Care (PC) doctors and a cardiology specialist in diagnosing left ventricular hypertrophy in the electrocardiograph (LVH-ECG) in hypertensive patients.
  
  
  METHODS
  Cross-sectional, multicentre study.
  
  
  METHODS
  Andalusian Primary Care Centres.
  
  
  METHODS
  A total of 120 PC doctors who using a random sample selected patients of 35 years or more with AHT of at least 6 months of progression. PRIMARY VARIABLES: Demographic data, risk factors and cardiovascular diseases were recorded. The LVH-ECG was evaluated by applying Cornell voltage criteria, Cornell and Sokolow-Lyon product. The PC researchers read the ECG first and the cardiologist made a second reading blind.
  
  
  RESULTS
  A total of 570 patients (mean +/- SD of age, 65 +/- 11 years; 54.5% females); the LVH-ECG prevalence was 13.7% (95% CI, 10.8-16.6; 12.6% by Cornell and 1.6% by Sokolow-Lyon). The agreement in the diagnosis between the PC doctors and the cardiologist was 0.378 (95% CI, 0.272-0.486; disagreements in 15.5% of cases). The PC doctors slightly underestimated the LVH-ECG prevalence by Cornell and slightly overestimated it by the Sokolow-Lyon criteria. The agreement was also low for all of them (kappa = 0.367; 95% CI, 0.252-0.482, for Cornell, and kappa = 0.274; 95% CI: 0.093-0.454 for Sokolow-Lyon).
  
  
  CONCLUSIONS
  The agreement between the diagnosis by the PC doctors and the cardiologist was low. The implications of this study suggest the need to improve the reading of ECG among PC doctors. The use of computerised systems could be a good option.
authors.affiliation: Centro de Salud Fuensanta, Distrito Sanitario Córdoba, Córdoba, España. enrique.martin@ono.com
authors.forename: Enrique
authors.initials: E
authors.lastname: Martín-Rioboó
authors.forename: Amador
authors.initials: A
authors.lastname: López Granados
authors.forename: Luis
authors.initials: L
authors.lastname: Cea Calvo
authors.forename: Luis Angel
authors.initials: LA
authors.lastname: Pérula De Torres
authors.forename: Emilio
authors.initials: E
authors.lastname: García Criado
authors.forename: Manuel P
authors.initials: MP
authors.lastname: Anguita Sánchez
authors.forename: Lisardo
authors.initials: L
authors.lastname: García Matarín
authors.forename: Rafael
authors.initials: R
authors.lastname: Molina Díaz
authors.forename: Tomas
authors.initials: T
authors.lastname: Ureña Fernández
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D015588:Observer Variation; D013030:Spain