Ebrahim Mohammad A, Alseid Reem K, Aleinati Raghad T, Tuzcu Volkan
Department of Pediatrics, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
Sidra Medicine, Heart Center, Doha, Qatar.
Ann Pediatr Cardiol. 2020 Jul-Sep;13(3):205-211. doi: 10.4103/apc.APC_18_20. Epub 2020 Jul 2.
This study assesses the competency of pediatricians in interpreting electrocardiograms (ECGs).
A cross-sectional study involving 125 pediatricians comprised of 71 general pediatricians, 15 pediatric cardiologists, and 39 other subspecialists recruited from all public hospitals and two specialty centers. Participants completed a questionnaire that included 10 ECGs and questions regarding backgrounds, attitudes, and practices. The ECGs were graded to obtain a knowledge score out of 30 points. Mann-Whitney U test and Kruskal-Wallis test with post hoc analysis and Bonferroni adjustment were used to compare groups.
The mean knowledge score ranged from 47.7% to 69.7% among various pediatric specialties ( = 0.006). Age, increasing years of experience, confidence level, number of cardiology referrals, and perceived importance of having good ECG interpretation skills were significantly related to the knowledge score ( ≤ 0.05). Accuracy was highest in identifying normal ECGs (76.8%), supraventricular tachycardia (64.8%), along with long QT interval (58.4%), and was lowest for right bundle branch block (RBBB) (10.4%), 2:1 atrioventricular conduction (10.4%), and atrial tachycardia (AT) (4.8%). Accuracy among pediatric cardiologists was highest for long QT interval (100%), normal ECG (80%), as well as Wolff-Parkinson-White syndrome (80%), and lowest for RBBB (13.3%) and AT (0%). Most pediatricians believe that ECGs are "useful" (78.4%) and that having good interpretation skill is "important" (80.6%).
Pediatricians recognize the importance of ECGs. However, their skill and level of accuracy at interpretation is suboptimal, including cardiologists, and may affect patient care. Thus, efforts should be made to improve ECG understanding to provide better service to patients.
本研究评估儿科医生解读心电图（ECG）的能力。
一项横断面研究，涉及125名儿科医生，包括从所有公立医院和两个专科中心招募的71名普通儿科医生、15名儿科心脏病专家和39名其他亚专科医生。参与者完成了一份问卷，其中包括10份心电图以及有关背景、态度和实践的问题。对心电图进行评分以获得满分30分的知识得分。采用Mann-Whitney U检验和Kruskal-Wallis检验，并进行事后分析和Bonferroni校正以比较各组。
不同儿科专业的平均知识得分在47.7%至69.7%之间（P = 0.006）。年龄、工作年限增加、信心水平、心脏病转诊次数以及对具备良好心电图解读技能的感知重要性与知识得分显著相关（P≤0.05）。识别正常心电图（76.8%）、室上性心动过速（64.8%）以及长QT间期（58.4%）时的准确率最高，而右束支传导阻滞（RBBB）（10.4%）、二度房室传导阻滞（10.4%）和房性心动过速（AT）（4.8%）的准确率最低。儿科心脏病专家对长QT间期（100%）、正常心电图（80%）以及预激综合征（80%）的诊断准确率最高，而对RBBB（13.3%）和AT（0%）的诊断准确率最低。大多数儿科医生认为心电图“有用”（78.4%），且具备良好的解读技能“很重要”（80.6%）。
儿科医生认识到心电图的重要性。然而，包括心脏病专家在内，他们的解读技能和准确性水平欠佳，可能会影响患者护理。因此，应努力提高对心电图的理解，以便为患者提供更好的服务。
