Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Department of Family Medicine, University of Washington, Seattle, Washington, USA.
Heart. 2018 Dec;104(24):2051-2057. doi: 10.1136/heartjnl-2018-313066. Epub 2018 Jul 4.
To assess the accuracy of interpreting the athlete's ECG both pre and post a series of online training modules among a range of healthcare professionals. 10 512 healthcare professionals from 138 different nations commenced the online course. These were primarily doctors (43%), nurses (18.4%) and other healthcare professionals (3.9%). The users came from 102 different specialities, with General Practice/Family Medicine (24.5%), Cardiology (10.6%), Emergency Medicine (8.7%) and Sports Medicine (6.6%) predominating. Among the 2023 users who completed both the pre-course and post-course test, there was an overall improvement of 15.3% (95% CI 13.9% to 16.6%; p<0.001). 930 completed all four other modules, and these users fared significantly better (18.7% increase; 95% CI 17.3 to 20.0) than those completing no additional modules (11.7% increase; 95% CI 3.3 to 17.7, p=0.036). Demographic analysis showed that while the starting pre-test scores varied significantly between profession/specialty groups (57.8%-82.6%), post-test scores were largely consistent (80.8%-84.6%). Although users showed the most improvement when interpreting primary electrical diseases (12.4% increase), it was also an area of notable weakness compared with the modules of normal training-related findings and cardiomyopathies. With the evolving criteria for ECG interpretation eliciting ever improving levels of specificity and sensitivity in the detection of conditions associated with sudden cardiac death among athletes, training is required to ensure the infrastructure and personnel is in place to uphold these standards. The BMJ Learning course presented is a valuable first step and demonstrates that such an online tool can be effective in aiding ECG interpretation among healthcare professionals globally.
评估一系列在线培训模块前后，医疗保健专业人员解读运动员心电图的准确性。来自 138 个不同国家的 10512 名医疗保健专业人员开始参加在线课程。这些人员主要是医生（43%）、护士（18.4%）和其他医疗保健专业人员（3.9%）。用户来自 102 个不同的专业，其中普通科/家庭医学（24.5%）、心脏病学（10.6%）、急诊医学（8.7%）和运动医学（6.6%）居多。在完成预测试和后测试的 2023 名用户中，总体提高了 15.3%（95%置信区间为 13.9%至 16.6%；p<0.001）。有 930 人完成了其他四个模块，这些用户的表现明显更好（增加 18.7%；95%置信区间为 17.3%至 20.0），而没有完成其他模块的用户增加了 11.7%（95%置信区间为 3.3%至 17.7，p=0.036）。人口统计学分析表明，虽然专业/专科组的初始预测试分数差异显著（57.8%-82.6%），但后测试分数差异不大（80.8%-84.6%）。虽然用户在解读原发性电疾病时的提高最为显著（增加 12.4%），但与正常训练相关发现和心肌病模块相比，这也是一个明显的薄弱环节。随着 ECG 解读标准的不断发展，在检测与运动员猝死相关的疾病时，特异性和敏感性不断提高，需要进行培训以确保基础设施和人员到位，以维持这些标准。本研究中呈现的 BMJ 学习课程是一个有价值的第一步，证明了这样一个在线工具可以有效地帮助全球医疗保健专业人员解读心电图。
