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Refinement and interobserver agreement for the electrocardiographic Sclarovsky-Birnbaum Ischemia Grading System

Billgren, T; Birnbaum, Y; Sgarbossa, E B; Sejersten, M; Hill, N E; Engblom, Henrik LU ; Maynard, C; Pahlm, O and Wagner, G S (2004) In Journal of Electrocardiology 37(3). p.149-156
Abstract
Background: Electrocardiogram-derived grades of ischemia at the time of patient presentation with acute myocardial infarction have proved useful in predicting the salvageability by reperfusion therapy, final infarct size, severity of left ventricular dysfunction, and short- and long-term prognosis. Subjects and Methods: The Sclarovsky-Birnbaum Ischemia Grading System based on the relation between the acute appearances of the T wave, the ST segment, and the QRS complex was considered as a means of enhanced ECG analysis in this group of patients. The evaluation of a training population (n = 46) resulted in refinement of the published description of the Sclarovsky-Birnbaum Ischemia Grading System, and a test population (n = 50) was utilized... (More)
Background: Electrocardiogram-derived grades of ischemia at the time of patient presentation with acute myocardial infarction have proved useful in predicting the salvageability by reperfusion therapy, final infarct size, severity of left ventricular dysfunction, and short- and long-term prognosis. Subjects and Methods: The Sclarovsky-Birnbaum Ischemia Grading System based on the relation between the acute appearances of the T wave, the ST segment, and the QRS complex was considered as a means of enhanced ECG analysis in this group of patients. The evaluation of a training population (n = 46) resulted in refinement of the published description of the Sclarovsky-Birnbaum Ischemia Grading System, and a test population (n = 50) was utilized for investigating the interobserver agreement among 5 observers in determining the grade of ischemia. Results: The agreement among the observers applying the "refined" Sclarovsky-Birnbaum Ischemia Grading System was 0.89. Complete agreement was found for the ECGs of 80% of the patients, and the most common reason for disagreement was the application of the terminal T-negativity criterion. Conclusions: The refined Sclarovsky-Birnbaum Ischemia Grading System can be performed manually with low interobserver variability. It has potential for support of the acute myocardial infarction triage decision as an electrocardiographic method for evaluating the level of ischemic protection at the time of either pre-hospital or emergency-department presentation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute myocardial ischemia, electrocardiography, grades of ischemia
in
Journal of Electrocardiology
volume
37
issue
3
pages
149 - 156
publisher
Elsevier
external identifiers
  • wos:000223406100002
  • pmid:15286927
  • scopus:3543041319
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2004.02.005
language
English
LU publication?
yes
id
f354b54f-8772-4d17-991e-583d6863914a (old id 269547)
date added to LUP
2007-10-17 09:33:41
date last changed
2017-01-15 03:27:26
@article{f354b54f-8772-4d17-991e-583d6863914a,
  abstract     = {Background: Electrocardiogram-derived grades of ischemia at the time of patient presentation with acute myocardial infarction have proved useful in predicting the salvageability by reperfusion therapy, final infarct size, severity of left ventricular dysfunction, and short- and long-term prognosis. Subjects and Methods: The Sclarovsky-Birnbaum Ischemia Grading System based on the relation between the acute appearances of the T wave, the ST segment, and the QRS complex was considered as a means of enhanced ECG analysis in this group of patients. The evaluation of a training population (n = 46) resulted in refinement of the published description of the Sclarovsky-Birnbaum Ischemia Grading System, and a test population (n = 50) was utilized for investigating the interobserver agreement among 5 observers in determining the grade of ischemia. Results: The agreement among the observers applying the "refined" Sclarovsky-Birnbaum Ischemia Grading System was 0.89. Complete agreement was found for the ECGs of 80% of the patients, and the most common reason for disagreement was the application of the terminal T-negativity criterion. Conclusions: The refined Sclarovsky-Birnbaum Ischemia Grading System can be performed manually with low interobserver variability. It has potential for support of the acute myocardial infarction triage decision as an electrocardiographic method for evaluating the level of ischemic protection at the time of either pre-hospital or emergency-department presentation.},
  author       = {Billgren, T and Birnbaum, Y and Sgarbossa, E B and Sejersten, M and Hill, N E and Engblom, Henrik and Maynard, C and Pahlm, O and Wagner, G S},
  issn         = {1532-8430},
  keyword      = {acute myocardial ischemia,electrocardiography,grades of ischemia},
  language     = {eng},
  number       = {3},
  pages        = {149--156},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Refinement and interobserver agreement for the electrocardiographic Sclarovsky-Birnbaum Ischemia Grading System},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2004.02.005},
  volume       = {37},
  year         = {2004},
}