Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey.
Telemed J E Health. 2012 Mar;18(2):126-31. doi: 10.1089/tmj.2011.0108. Epub 2012 Jan 27.
In this study, the diagnostic accuracy of interpretations of electrocardiogram (ECG) images taken by a mobile phone and sent as multimedia message was investigated.
The ECGs of 305 patients who were admitted to the emergency department with cardiac complaints were photographed with the camera of a Nokia (Espoo, Finland) N93 mobile phone. The images were sent via a multimedia messaging system to an identical mobile phone carried by a cardiologist and were interpreted on the screen of that mobile phone. Another cardiologist and an emergency physician interpreted ECG paper printouts separately. The findings of the core laboratory were used as the gold standard. The interpretation errors were scaled from 1 to 4 with respect to the significance of findings.
The total ratio of Grade 4 errors, which consisted of significant errors, did not show any significant difference (p=0.76) between the interpretations by the emergency medicine specialist and the cardiologist who interpreted the ECGs on the mobile phone; the cardiologist who interpreted the ECG paper printouts made significantly fewer mistakes than the other two specialists (p=0.025 and p=0.023, respectively). The separate assessment of the findings showed that in the diagnostic process of ST-segment elevation, depression, and supraventricular tachycardia, the consistency of the interpretations (κ=0.81, κ=0.81, and κ=1.0, respectively) made on the mobile phone screen was slightly better than that of the emergency medicine specialist (κ=0.73, κ=0.77, and κ=0.80, respectively) and was similar to that of the cardiologist (κ=0.91, κ=0.91, and κ=1.0, respectively) who interpreted ECG paper printouts.
Our findings suggest that sending the ECG images via a multimedia message service may be a practical and inexpensive telecardiology procedure.
本研究旨在探讨通过手机拍摄并以多媒体短信形式发送的心电图（ECG）图像的诊断准确性。
使用诺基亚（芬兰埃斯波）N93 手机的摄像头对 305 例因心脏不适而收入急诊的患者进行 ECG 拍摄。将图像通过多媒体消息系统发送至携带相同手机的心脏病专家的手机上，并在该手机屏幕上进行解读。另一名心脏病专家和一名急诊医生分别对心电图打印件进行解读。以核心实验室的结果为金标准。根据发现的重要程度，将解读错误从 1 级到 4 级进行评分。
在包含重大错误的 4 级错误的总比例方面，通过手机解读 ECG 的急诊医学专家与心脏病专家之间的差异无统计学意义（p=0.76）；与其他两名专家相比，解读心电图打印件的心脏病专家错误明显更少（p=0.025 和 p=0.023）。对各项发现的单独评估显示，在 ST 段抬高、压低和室上性心动过速的诊断过程中，在手机屏幕上进行的解读（κ=0.81、κ=0.81 和 κ=1.0）的一致性略优于急诊医学专家（κ=0.73、κ=0.77 和 κ=0.80），与解读心电图打印件的心脏病专家（κ=0.91、κ=0.91 和 κ=1.0）的一致性相似。
我们的研究结果表明，通过多媒体消息服务发送 ECG 图像可能是一种实用且经济的远程心脏病学方法。
