Evaluation of the photo-electrocardiogram as a tool for formative second opinion

• Autor(a) principal: Canabarro, Ana Paula Finatto
• Data de Publicação: 2014
• Outros Autores: Schwalbert, Ângelo Marcelo, Cardoso, Ricardo Bertoglio, Valdez, Clarissa Francisca, Trindade, Carolina Sturm, de Oliveira, Helena Wihelm, Lamadrid, Ingrid Gradaschi, Russomano, Thais
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Scientia Medica (Porto Alegre. Online)
• Texto Completo: https://revistaseletronicas.pucrs.br/scientiamedica/article/view/1980-6108.2013.4.15150
• topic: TELEMEDICINE; CELLULAR PHONE; DIAGNOSTIC TECHNIQUES; CARDIOVASCULAR; ELETROCARDIOGRAPHY.; TELEMEDICINA; TELEFONE CELULAR; TÉCNICAS DE DIAGNÓSTICO CARDIOVASCULAR; ELETROCARDIOGRAFIA.

AIMS: This study aimed to evaluate the photo-electrocardiogram (photo-ECG), as an alternative tool to enable remote formative second opinion in cardiology. METHODS: Fifty paper electrocardiograms (ECGs) were photographed two times, the first using a Canon digital camera, 0.3 megapixel resolution, and the second using a Nokia mobile phone integrated camera, 2.0 megapixel resolution, resulting in 100 Photo-ECGs. A pilot study was responsible for determining the acquisition method. The 100 Photo-ECGs were randomized, encrypted and sent by e-mail to a remote cardiologist, while the 50 paper ECGs were delivered to him in person, without randomization. Gender and age were the only patient information made available to the specialist. RESULTS: Data analysis demonstrated a disagreement in 14 of 50 interpretations (28%) when comparing paper ECGs to the Canon camera photo-ECGs and in 13 of 50 interpretations (26%) when comparing paper ECGs to the Nokia camera photo-ECGs. The Kappa test revealed a fair agreement (Kappa=0.356) between interpretations when comparing the original ECGs to their respective photo-ECGs for both camera devices. CONCLUSIONS: The concordance between photo-ECGs and original tracings demonstrated that the method described herein has the potential for use as a tool to assist clinical practice, provided that the acquisition of photo-ECGs is adapted so as to improve exam images. Only with good to very good concordance between the original ECGs and photo-ECGs will remote formative second opinion be possible, giving better diagnostic and therapeutic options.