Do you rely on the machine's ecg diagnosis?
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Cardiology
Do you rely on the machine's ecg diagnosis?
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One of my colleagues sent me this ecg which the machine reported as 'old lateral infarct' - do you agree?
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Forums » Open clinical » Cardiology » Do you rely on the machine's ecg diagnosis?
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Re: Do you rely on the machine's ecg diagnosis?
posted at 14/5/2012 10:13 AM BST
on bmj.com
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Posts: 3037
First: 27/3/2012 Last: 18/5/2013 |
No Dr. Sadian! It is in fact an ECG showing Type A WPW syndrome with secondary ST-T changes, especially ST coving seen in the lateral leads. We must correlate an ECG with the clinical findings & so is it that we should acquire the ECG ourselves! We should not rely on the machine diagnosis, but the quantitative analysis does help us in saving our valuable time. |
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Re: Do you rely on the machine's ecg diagnosis?
posted at 15/5/2012 1:04 PM BST
on bmj.com
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Posts: 3037
First: 27/3/2012 Last: 18/5/2013 |
In Response to Re: Do you rely on the machine's ecg diagnosis?: You are correct Dr Ashutosh - exactly what I told my colleague (plus perhaps machines wouldn't replace doctors just yet!) sadian Posted by sadian Many thanks for your encouraging comments Dr. Sadian! |
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Re: Do you rely on the machine's ecg diagnosis?
posted at 15/5/2012 1:18 PM BST
on bmj.com
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Posts: 3037
First: 27/3/2012 Last: 18/5/2013 |
In Response to Re: Do you rely on the machine's ecg diagnosis?: What about this one? The machine says AF. sadian Posted by sadian After a careful look at the ECG, you will notice a baseline artifact, especially in the limb leads, while the precordial leads showing normal P pattern, So, it appears a loose lead contact of the limb leads causing an artifact simulating AF! |
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Re: Do you rely on the machine's ecg diagnosis?
posted at 18/5/2012 8:20 PM BST
on bmj.com
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Posts: 27
First: 25/9/2011 Last: 13/2/2013 |
I suspect the machine's internal diagnostic protocols are set at a level to detect absloutely all abnormalities and by doing so have a low specificity while a reasonably high sensitvity. This appears to be done to cover the various "knowledge defects" of multiple users ie deferring to the lowest common denominator in a practice. My own view is the self-diagnostic print out is potentially medico-legally damaging and the management of the patient tends to default to what is printed on the report NOT on the clinical needs. For this reason I like the self diagnostic function switched off so that I am forced to make a decision that includes the whole problem and likely diagnoses. I even practiced in a small clinic without an ECG machine for several years and this is a particulalry good way of sharpening up your clinical practice ( but not as much fun as I quite like "gadgets"). Great topic to raise. Thanks.
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Re: Do you rely on the machine's ecg diagnosis?
posted at 19/5/2012 12:12 AM BST
on bmj.com
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Posts: 3037
First: 27/3/2012 Last: 18/5/2013 |
In Response to Re: Do you rely on the machine's ecg diagnosis?: I suspect the machine's internal diagnostic protocols are set at a level to detect absloutely all abnormalities and by doing so have a low specificity while a reasonably high sensitvity. This appears to be done to cover the various "knowledge defects" of multiple users ie deferring to the lowest common denominator in a practice. My own view is the self-diagnostic print out is potentially medico-legally damaging and the management of the patient tends to default to what is printed on the report NOT on the clinical needs. For this reason I like the self diagnostic function switched off so that I am forced to make a decision that includes the whole problem and likely diagnoses. I even practiced in a small clinic without an ECG machine for several years and this is a particulalry good way of sharpening up your clinical practice ( but not as much fun as I quite like "gadgets"). Great topic to raise. Thanks. Posted by ionabottom Although reports provided by ECG machine are not completely reliable & may impose some medicolegal aspects, we should not rely on the machine diagnosis but at the same time it is perfectly helpful to us in the quantitative analysis & may perhaps help us in detection of an unidentified arrhythmia. |
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Re: Do you rely on the machine's ecg diagnosis?
posted at 19/5/2012 12:20 PM BST
on bmj.com
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Posts: 33
First: 11/2/2011 Last: 2/5/2013 |
I agree with Ashutosh; the times for PR, QRS and QTc as well as Axes tend to be accurate. Arguable the machines are better at measuring accurately than a human and therefore I do glance at the numbers to make sure the corroborate with my impression. As far as diagnostics, they machine does over interpret the findings and therefore this 'interpretation' isn't helpful at all. Conclusion: Rely on machine's 'measurements', no 'interpretations'. This probably holds true for all devices! |
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Re: Do you rely on the machine's ecg diagnosis?
posted at 19/5/2012 1:01 PM BST
on bmj.com
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Posts: 9
First: 19/5/2012 Last: 19/5/2012 |
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Forums » Open clinical » Cardiology » Do you rely on the machine's ecg diagnosis?
