Abstract 11076: Can Preparticipation Screening Electrocardiograms be Interpreted Accurately?
Background: Preparticipation screening ECGs have been promoted for prevention of sudden cardiac death (SCD) in young athletes, although the effectiveness is unknown.
Objective: To evaluate the accuracy of pediatric cardiologists' interpretations of ECGs.
Methods: Eighteen ECGs representing conditions causing SCD in children or normal hearts were interpreted by members of the Western Society of Pediatric Cardiology. Gold standard diagnoses and recommendations were determined by two electrophysiologists (100% concordance).
Results: Fifty-three pediatric cardiologists participated. The average number of correct diagnoses per respondent was 12 ± 2.9. Accuracy was 67% (range 50%-96%). (See Table). Respondents achieved a sensitivity of 60% and specificity of 89% for recognition of any disease. Sports participation was accurately permitted in 74% of cases. Respondents correctly restricted sports participation 81% of the time, most accurately in Long QT syndrome and myocarditis (98%, 90% respectively) and least in hypertrophic cardiomyopathy and Wolff-Parkinson-White (80%, 64% respectively). Respondents ordered 75% more follow up tests than experts.
Conclusions: Preparticipation screening ECGs are difficult to interpret accurately. This leads to inappropriate sports exclusion and inclusion rates of 19% and 26% respectively. A consequence of diagnostic error is overutilization of ancillary diagnostic tests.
- © 2010 by American Heart Association, Inc.