García Olmos L, Alonso M T, Olmos O, Barrios M, Arias P, Carratalá F J
Centro de Salud de Alcobendas, Madrid.
Aten Primaria. 1990 Oct;7(9):551-2, 554, 556.
We evaluated the usefulness of ECG in the follow up of 223 hypertensive patients included in a program for the control of hypertension. Yearly ECG was requested in 84.3% of the evaluated patients. Its interpretation resulted in therapeutic changes in 6 patients. The agreement of the interpretation of 122 ECG tracings between the primary care team and a cardiologist was moderate. General practitioners overrated normality (87 versus 69 cases), and underdiagnosed left ventricular hypertrophy (6 versus 10 cases) and ischemic heart disease (6 versus 17 cases). Half of the diagnoses of ischemic heart disease made by the general practitioner were not accepted by the cardiologist. The compliance with a protocol does not guarantee a higher quality of care.
我们评估了心电图在纳入高血压控制项目的223例高血压患者随访中的作用。84.3%的评估患者被要求每年进行心电图检查。其解读导致6例患者治疗方案改变。基层医疗团队与心脏病专家对122份心电图描记的解读一致性为中等。全科医生高估了正常情况(87例对69例),对左心室肥厚(6例对10例)和缺血性心脏病(6例对17例)诊断不足。全科医生做出的缺血性心脏病诊断中有一半未被心脏病专家认可。遵循方案并不能保证更高的医疗质量。