Evaluation of the photo-electrocardiogram as a tool for formative second opinion
- Autores: Ana Paula Finatto Canabarro, Ângelo Marcelo Schwalbert, Ricardo Bertoglio Cardoso, Clarissa Francisca Valdez, Carolina Sturm Trindade, Helena Wihelm de Oliveira, Ingrid Gradaschi Lamadrid, Thais Russomano
- Localización: Scientia Medica, ISSN-e 1980-6108, Vol. 23, Nº. 4, 2013
- Idioma: inglés
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Resumen
AIMS: This study aimed to evaluate the photo-electrocardiogram (photo-ECG), as an alternative tool to enable remote formative second opinion in cardiology.
METHODS: Fifty paper electrocardiograms (ECGs) were photographed two times, the first using a Canon digital camera, 0.3 megapixel resolution, and the second using a Nokia mobile phone integrated camera, 2.0 megapixel resolution, resulting in 100 Photo-ECGs. A pilot study was responsible for determining the acquisition method. The 100 Photo-ECGs were randomized, encrypted and sent by e-mail to a remote cardiologist, while the 50 paper ECGs were delivered to him in person, without randomization. Gender and age were the only patient information made available to the specialist.
RESULTS: Data analysis demonstrated a disagreement in 14 of 50 interpretations (28%) when comparing paper ECGs to the Canon camera photo-ECGs and in 13 of 50 interpretations (26%) when comparing paper ECGs to the Nokia camera photo-ECGs. The Kappa test revealed a fair agreement (Kappa=0.356) between interpretations when comparing the original ECGs to their respective photo-ECGs for both camera devices.
CONCLUSIONS: The concordance between photo-ECGs and original tracings demonstrated that the method described herein has the potential for use as a tool to assist clinical practice, provided that the acquisition of photo-ECGs is adapted so as to improve exam images. Only with good to very good concordance between the original ECGs and photo-ECGs will remote formative second opinion be possible, giving better diagnostic and therapeutic options.
