节律性紊乱：计算机心电图诊断中的异常情况
Rhythmic chaos: irregularities of computer ECG diagnosis.
作者信息
Wang Yi-Ting Laureen, Seow Swee-Chong, Singh Devinder, Poh Kian-Keong, Chai Ping
机构信息
Department of Cardiology, National University Health System, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
出版信息
Singapore Med J. 2017 Sep;58(9):516-520. doi: 10.11622/smedj.2017088.
Abstract
Diagnostic errors can occur when physicians rely solely on computer electrocardiogram interpretation. Cardiologists often receive referrals for computer misdiagnoses of atrial fibrillation. Patients may have been inappropriately anticoagulated for pseudo atrial fibrillation. Anticoagulation carries significant risks, and such errors may carry a high cost. Have we become overreliant on machines and technology? In this article, we illustrate three such cases and briefly discuss how we can reduce these errors.
摘要
当医生仅仅依赖计算机心电图解读时，可能会出现诊断错误。心脏病专家经常收到因计算机对房颤误诊而转来的病例。患者可能因假性房颤而接受了不适当的抗凝治疗。抗凝治疗存在重大风险，此类错误可能代价高昂。我们是否过度依赖机器和技术了呢？在本文中，我们举例说明三个这样的病例，并简要讨论如何减少这些错误。
相似文献
1
Rhythmic chaos: irregularities of computer ECG diagnosis.节律性紊乱：计算机心电图诊断中的异常情况
Singapore Med J. 2017 Sep;58(9):516-520. doi: 10.11622/smedj.2017088.
2
Misdiagnosis of atrial fibrillation and its clinical consequences.心房颤动的误诊及其临床后果。
Am J Med. 2004 Nov 1;117(9):636-42. doi: 10.1016/j.amjmed.2004.06.024.
3
Accuracy of electrocardiogram interpretation by cardiologists in the setting of incorrect computer analysis.在计算机分析结果错误的情况下，心脏病专家解读心电图的准确性。
J Electrocardiol. 2006 Jul;39(3):343-5. doi: 10.1016/j.jelectrocard.2006.02.002.
4
Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting.手持式心电图设备在心脏病学和老年病科病房环境中检测心房颤动的性能。
Europace. 2017 Jan;19(1):29-39. doi: 10.1093/europace/euw025. Epub 2016 Feb 17.
5
Analysis of atrial fibrillation: from electrocardiogram signal processing to clinical management.
Philos Trans A Math Phys Eng Sci. 2009 Jan 28;367(1887):235-53. doi: 10.1098/rsta.2008.0162.
6
Computer misdiagnosis of AIVR as atrial fibrillation.计算机将加速性室性自主心律误诊为心房颤动。
J Electrocardiol. 2016 May-Jun;49(3):476-7. doi: 10.1016/j.jelectrocard.2016.02.007. Epub 2016 Feb 10.
7
Computer error and acceptable standards for electrocardiographic interpretation.计算机错误与心电图解读的可接受标准。
J Electrocardiol. 2006 Jul;39(3):348-9. doi: 10.1016/j.jelectrocard.2006.03.003. Epub 2006 May 12.
8
Physician practices regarding anticoagulation and cardioversion of atrial fibrillation.医生关于心房颤动抗凝和复律的诊疗实践。
Arch Intern Med. 1996 Feb 12;156(3):290-4.
9
Clinically important atrial arrhythmia and stroke risk: a UK-wide online survey among stroke physicians and cardiologists.临床重要的心房性心律失常和卒中风险：英国范围内卒中医生和心脏病学家的在线调查。
QJM. 2014 Nov;107(11):895-902. doi: 10.1093/qjmed/hcu177. Epub 2014 Aug 29.
10
Atrial fibrillation subtypes classification using the General Fourier-family Transform.使用广义傅里叶族变换进行心房颤动亚型分类。
Med Eng Phys. 2014 Apr;36(4):554-60. doi: 10.1016/j.medengphy.2013.12.005. Epub 2013 Dec 28.
本文引用的文献
1
Electrocardiographic artefacts mimicking atrial tachycardia resulted in unnecessary diagnostic and therapeutic measures.心电图伪差模拟房性心动过速导致不必要的诊断和治疗措施。
Korean J Intern Med. 2013 Mar;28(2):224-30. doi: 10.3904/kjim.2013.28.2.224. Epub 2013 Feb 27.
2
Erroneous computer electrocardiogram interpretation of atrial fibrillation and its clinical consequences.错误的计算机心电图对心房颤动的解读及其临床后果。
Clin Cardiol. 2012 Jun;35(6):348-53. doi: 10.1002/clc.22000. Epub 2012 May 29.
3
Misleading ECG recordings.心电图误导。
Singapore Med J. 2011 Nov;52(11):772-5; quiz 776.
4
Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation.采用新型基于风险因素的方法对房颤患者的卒中与血栓栓塞风险进行临床分层的研究：房颤的欧洲心脏调查。
Chest. 2010 Feb;137(2):263-72. doi: 10.1378/chest.09-1584. Epub 2009 Sep 17.
5
Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians.医生在心电图诊断心房颤动时出现错误的原因。
J Electrocardiol. 2007 Sep-Oct;40(5):450-6. doi: 10.1016/j.jelectrocard.2007.01.003. Epub 2007 Feb 22.
6
Misdiagnosis of atrial fibrillation and its clinical consequences.心房颤动的误诊及其临床后果。
Am J Med. 2004 Nov 1;117(9):636-42. doi: 10.1016/j.amjmed.2004.06.024.
7
Computer decision support as a source of interpretation error: the case of electrocardiograms.作为解释错误来源的计算机决策支持：心电图案例
J Am Med Inform Assoc. 2003 Sep-Oct;10(5):478-83. doi: 10.1197/jamia.M1279. Epub 2003 Jun 4.
8
Competency in interpretation of 12-lead electrocardiograms: a summary and appraisal of published evidence.12导联心电图解读能力：已发表证据的总结与评估
Ann Intern Med. 2003 May 6;138(9):751-60. doi: 10.7326/0003-4819-138-9-200305060-00013.
9
Enhancement of clinicians' diagnostic reasoning by computer-based consultation: a multisite study of 2 systems.基于计算机的会诊对临床医生诊断推理能力的提升：两个系统的多中心研究
JAMA. 1999 Nov 17;282(19):1851-6. doi: 10.1001/jama.282.19.1851.
10
The effects of computer-assisted electrocardiographic interpretation on physicians' diagnostic decisions.计算机辅助心电图解读对医生诊断决策的影响。
Med Decis Making. 1995 Apr-Jun;15(2):107-12. doi: 10.1177/0272989X9501500202.
Zotero 插件