Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs
Autor(a) principal: | |
---|---|
Data de Publicação: | 2024 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Semina. Ciências Agrárias (Online) |
Texto Completo: | https://ojs.uel.br/revistas/uel/index.php/semagrarias/article/view/47654 |
Resumo: | Abstract: The electrocardiogram, which graphically records the phases of the cardiac cycle, plays a crucial role in diagnosing arrhythmias and conduction abnormalities. However, the reliability of results can be significantly affected by the level of expertise of the evaluator. Acknowledging potential discrepancies in interpretations of the same electrocardiographic readings across different cardiac cycles and between analysts of varying experience, this study aimed to assess the interobserver and inter-cycle variability in electrocardiographic exams of dogs. This retrospective research was carried out at the Veterinary Hospital Superintendency Unit of the Federal University of Fronteira Sul, Realeza Campus, PR, Brazil. The study involved a random selection of electrocardiographic records from 50 dogs, collected between September 2018 and December 2019, without discrimination based on breed, sex, age, or weight. Various parameters were analyzed, including heart rate and rhythm; durations of P waves; QRS complexes; PR and QT intervals; amplitudes of P, R, and T waves; and both atrial and ventricular electrical axes. The data underwent Shapiro-Wilk normality testing, with parametric data analyzed via analysis of variance and Tukey's test, and non-parametric data assessed using the Kruskal-Wallis followed by Dunn's tests. The final step involved applying the Kappa Agreement Coefficient Test to the data. The findings revealed variability in heart rhythm interpretation, with disagreement between evaluators of low to intermediate experience levels. Specifically, low-level evaluators tended to underestimate maximum heart rates, recording a median rate of 105, compared to 122 by high-level evaluators (p=0.0100). Additionally, P wave durations were consistently overestimated by low- and intermediate-level evaluators, who reported median durations of 52 and 51, respectively, against 48 by their highly experienced counterparts (p=0.0064). No significant differences emerged in analyses comparing a single cardiac cycle to either three cycles or the average of three cycles. The study highlighted the impact of evaluator expertise on the variability of electrocardiographic interpretations, particularly concerning P wave duration, for which the evaluators tended to overestimate measurements, and the degrees of agreement, which did not represent their experience level. The findings stress the importance of training and routine practice in electrocardiographic examinations to mitigate the risk of mistaken interpretations and analyses. |
id |
UEL-11_95854577554f4f08201fb3e1a49c4bfd |
---|---|
oai_identifier_str |
oai:ojs.pkp.sfu.ca:article/47654 |
network_acronym_str |
UEL-11 |
network_name_str |
Semina. Ciências Agrárias (Online) |
repository_id_str |
|
spelling |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogsVariabilidade interobservador e entre ciclos cardíacos na avaliação eletrocardiográfica de cãesHeart rateElectrocardiogramLevel of experienceObservation errors.Ritmo cardíacoEletrocardiogramaNível de experiênciaErros de observação. Abstract: The electrocardiogram, which graphically records the phases of the cardiac cycle, plays a crucial role in diagnosing arrhythmias and conduction abnormalities. However, the reliability of results can be significantly affected by the level of expertise of the evaluator. Acknowledging potential discrepancies in interpretations of the same electrocardiographic readings across different cardiac cycles and between analysts of varying experience, this study aimed to assess the interobserver and inter-cycle variability in electrocardiographic exams of dogs. This retrospective research was carried out at the Veterinary Hospital Superintendency Unit of the Federal University of Fronteira Sul, Realeza Campus, PR, Brazil. The study involved a random selection of electrocardiographic records from 50 dogs, collected between September 2018 and December 2019, without discrimination based on breed, sex, age, or weight. Various parameters were analyzed, including heart rate and rhythm; durations of P waves; QRS complexes; PR and QT intervals; amplitudes of P, R, and T waves; and both atrial and ventricular electrical axes. The data underwent Shapiro-Wilk normality testing, with parametric data analyzed via analysis of variance and Tukey's test, and non-parametric data assessed using the Kruskal-Wallis followed by Dunn's tests. The final step involved applying the Kappa Agreement Coefficient Test to the data. The findings revealed variability in heart rhythm interpretation, with disagreement between evaluators of low to intermediate experience levels. Specifically, low-level evaluators tended to underestimate maximum heart rates, recording a median rate of 105, compared to 122 by high-level evaluators (p=0.0100). Additionally, P wave durations were consistently overestimated by low- and intermediate-level evaluators, who reported median durations of 52 and 51, respectively, against 48 by their highly experienced counterparts (p=0.0064). No significant differences emerged in analyses comparing a single cardiac cycle to either three cycles or the average of three cycles. The study highlighted the impact of evaluator expertise on the variability of electrocardiographic interpretations, particularly concerning P wave duration, for which the evaluators tended to overestimate measurements, and the degrees of agreement, which did not represent their experience level. The findings stress the importance of training and routine practice in electrocardiographic examinations to mitigate the risk of mistaken interpretations and analyses.O eletrocardiograma representa o registro gráfico das fases do ciclo cardíaco e é utilizado para o diagnóstico de arritmias ou distúrbios de condução. No entanto, a confiabilidade dos resultados pode ser influenciada pelo grau de experiência dos avaliadores. Devido à possibilidade de variação de resultados de um mesmo exame entre os ciclos cardíacos e entre analisadores de diferentes níveis de experiência, o estudo teve como objetivo avaliar a variabilidade interobservador e entre ciclos cardíacos durante a avaliação de exames eletrocardiográficos de cães. A pesquisa foi conduzida de forma retrospectiva na Superintendência Unidade Hospitalar Veterinária Universitária da Universidade Federal da Fronteira Sul, Campus Realeza – PR. Para a análise eletrocardiográfica foram selecionados aleatoriamente exames de 50 cães, gravados em arquivos computadorizados durante o período de setembro de 2018 a dezembro de 2019, independente da raça, sexo, idade e peso. Foram avaliados frequência e ritmo cardíaco, durações de onda P, complexo QRS, intervalo PR e intervalo QT, amplitudes de onda P, R e T, e eixo elétrico atrial e ventricular. Os dados foram analisados por teste de normalidade de Shapiro-Wilk, sendo os dados paramétricos analisados por análise de variância seguido por Teste de Tukey e os dados não paramétricos pelo Teste de Kruskal-Wallis, seguido pelo Teste de Dunn. Como última etapa, os dados foram submetidos ao Teste de Coeficiente de Concordância de Kappa. Evidenciou-se variabilidade na interpretação de ritmos cardíacos com discordância de avaliadores de nível baixo e intermediário, diferença da frequência cardíaca máxima do avaliador de baixo nível de experiência que subestimou os valores, obtendo mediana de 105, enquanto o de alto nível obteve mediana de 122 (p=0,0100). Ainda, evidenciou-se superestimação da duração da onda P pelos avaliadores de nível baixo e intermediário, que encontraram medianas de 52 e 51 respectivamente, enquanto o de alto nível obteve mediana de 48 (p=0,0064). Em relação a diferentes ciclos cardíacos, não houve diferenças entre a análise de apenas um ciclo em relação a três ciclos ou a média de três ciclos. Por meio do estudo foi possível evidenciar a variabilidade na interpretação entre avaliadores com diferentes níveis de experiência, em relação a duração da onda P, em que os avaliadores superestimaram os valores e em relação aos graus de concordância que não representaram os níveis de experiência dos avaliadores na análise do todas as variáveis, ressaltando a importância do treinamento e rotina de exames eletrocardiográficos para evitar interpretações e análises equivocadas.UEL2024-02-20info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://ojs.uel.br/revistas/uel/index.php/semagrarias/article/view/4765410.5433/1679-0359.2024v45n1p177Semina: Ciências Agrárias; Vol. 45 No. 1 (2024); 177-192Semina: Ciências Agrárias; v. 45 n. 1 (2024); 177-1921679-03591676-546Xreponame:Semina. Ciências Agrárias (Online)instname:Universidade Estadual de Londrina (UEL)instacron:UELenghttps://ojs.uel.br/revistas/uel/index.php/semagrarias/article/view/47654/50056Copyright (c) 2024 Semina: Ciências Agráriashttp://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessGnoatto, Fernando Luis CemenciGianezini, Estela Dall'AgnolMinuzzo, TaináChampion, Tatiana2024-04-16T11:59:01Zoai:ojs.pkp.sfu.ca:article/47654Revistahttp://www.uel.br/revistas/uel/index.php/semagrariasPUBhttps://ojs.uel.br/revistas/uel/index.php/semagrarias/oaisemina.agrarias@uel.br1679-03591676-546Xopendoar:2024-04-16T11:59:01Semina. Ciências Agrárias (Online) - Universidade Estadual de Londrina (UEL)false |
dc.title.none.fl_str_mv |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs Variabilidade interobservador e entre ciclos cardíacos na avaliação eletrocardiográfica de cães |
title |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs |
spellingShingle |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs Gnoatto, Fernando Luis Cemenci Heart rate Electrocardiogram Level of experience Observation errors. Ritmo cardíaco Eletrocardiograma Nível de experiência Erros de observação. |
title_short |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs |
title_full |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs |
title_fullStr |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs |
title_full_unstemmed |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs |
title_sort |
Interobserver and inter-cycle variability in the electrocardiographic assessment of dogs |
author |
Gnoatto, Fernando Luis Cemenci |
author_facet |
Gnoatto, Fernando Luis Cemenci Gianezini, Estela Dall'Agnol Minuzzo, Tainá Champion, Tatiana |
author_role |
author |
author2 |
Gianezini, Estela Dall'Agnol Minuzzo, Tainá Champion, Tatiana |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Gnoatto, Fernando Luis Cemenci Gianezini, Estela Dall'Agnol Minuzzo, Tainá Champion, Tatiana |
dc.subject.por.fl_str_mv |
Heart rate Electrocardiogram Level of experience Observation errors. Ritmo cardíaco Eletrocardiograma Nível de experiência Erros de observação. |
topic |
Heart rate Electrocardiogram Level of experience Observation errors. Ritmo cardíaco Eletrocardiograma Nível de experiência Erros de observação. |
description |
Abstract: The electrocardiogram, which graphically records the phases of the cardiac cycle, plays a crucial role in diagnosing arrhythmias and conduction abnormalities. However, the reliability of results can be significantly affected by the level of expertise of the evaluator. Acknowledging potential discrepancies in interpretations of the same electrocardiographic readings across different cardiac cycles and between analysts of varying experience, this study aimed to assess the interobserver and inter-cycle variability in electrocardiographic exams of dogs. This retrospective research was carried out at the Veterinary Hospital Superintendency Unit of the Federal University of Fronteira Sul, Realeza Campus, PR, Brazil. The study involved a random selection of electrocardiographic records from 50 dogs, collected between September 2018 and December 2019, without discrimination based on breed, sex, age, or weight. Various parameters were analyzed, including heart rate and rhythm; durations of P waves; QRS complexes; PR and QT intervals; amplitudes of P, R, and T waves; and both atrial and ventricular electrical axes. The data underwent Shapiro-Wilk normality testing, with parametric data analyzed via analysis of variance and Tukey's test, and non-parametric data assessed using the Kruskal-Wallis followed by Dunn's tests. The final step involved applying the Kappa Agreement Coefficient Test to the data. The findings revealed variability in heart rhythm interpretation, with disagreement between evaluators of low to intermediate experience levels. Specifically, low-level evaluators tended to underestimate maximum heart rates, recording a median rate of 105, compared to 122 by high-level evaluators (p=0.0100). Additionally, P wave durations were consistently overestimated by low- and intermediate-level evaluators, who reported median durations of 52 and 51, respectively, against 48 by their highly experienced counterparts (p=0.0064). No significant differences emerged in analyses comparing a single cardiac cycle to either three cycles or the average of three cycles. The study highlighted the impact of evaluator expertise on the variability of electrocardiographic interpretations, particularly concerning P wave duration, for which the evaluators tended to overestimate measurements, and the degrees of agreement, which did not represent their experience level. The findings stress the importance of training and routine practice in electrocardiographic examinations to mitigate the risk of mistaken interpretations and analyses. |
publishDate |
2024 |
dc.date.none.fl_str_mv |
2024-02-20 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://ojs.uel.br/revistas/uel/index.php/semagrarias/article/view/47654 10.5433/1679-0359.2024v45n1p177 |
url |
https://ojs.uel.br/revistas/uel/index.php/semagrarias/article/view/47654 |
identifier_str_mv |
10.5433/1679-0359.2024v45n1p177 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://ojs.uel.br/revistas/uel/index.php/semagrarias/article/view/47654/50056 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2024 Semina: Ciências Agrárias http://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2024 Semina: Ciências Agrárias http://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
UEL |
publisher.none.fl_str_mv |
UEL |
dc.source.none.fl_str_mv |
Semina: Ciências Agrárias; Vol. 45 No. 1 (2024); 177-192 Semina: Ciências Agrárias; v. 45 n. 1 (2024); 177-192 1679-0359 1676-546X reponame:Semina. Ciências Agrárias (Online) instname:Universidade Estadual de Londrina (UEL) instacron:UEL |
instname_str |
Universidade Estadual de Londrina (UEL) |
instacron_str |
UEL |
institution |
UEL |
reponame_str |
Semina. Ciências Agrárias (Online) |
collection |
Semina. Ciências Agrárias (Online) |
repository.name.fl_str_mv |
Semina. Ciências Agrárias (Online) - Universidade Estadual de Londrina (UEL) |
repository.mail.fl_str_mv |
semina.agrarias@uel.br |
_version_ |
1799306055175372800 |