Erroneous computer-based interpretations of atrial fibrillation and atrial flutter in a Swedish primary health care setting
(2019) In Scandinavian Journal of Primary Health Care 37(4). p.426-433- Abstract
Objective: To describe the incidence of incorrect computerized ECG interpretations of atrial fibrillation or atrial flutter in a Swedish primary care population, the rate of correction of computer misinterpretations, and the consequences of misdiagnosis. Design: Retrospective expert re-analysis of ECGs with a computer-suggested diagnosis of atrial fibrillation or atrial flutter. Setting: Primary health care in Region Kronoberg, Sweden. Subjects: All adult patients who had an ECG recorded between January 2016 and June 2016 with a computer statement including the words ‘atrial fibrillation’ or ‘atrial flutter’. Main outcome measures: Number of incorrect computer interpretations of atrial fibrillation or atrial flutter; rate of correction... (More)
Objective: To describe the incidence of incorrect computerized ECG interpretations of atrial fibrillation or atrial flutter in a Swedish primary care population, the rate of correction of computer misinterpretations, and the consequences of misdiagnosis. Design: Retrospective expert re-analysis of ECGs with a computer-suggested diagnosis of atrial fibrillation or atrial flutter. Setting: Primary health care in Region Kronoberg, Sweden. Subjects: All adult patients who had an ECG recorded between January 2016 and June 2016 with a computer statement including the words ‘atrial fibrillation’ or ‘atrial flutter’. Main outcome measures: Number of incorrect computer interpretations of atrial fibrillation or atrial flutter; rate of correction by the interpreting primary care physician; consequences of misdiagnosis of atrial fibrillation or atrial flutter. Results: Among 988 ECGs with a computer diagnosis of atrial fibrillation or atrial flutter, 89 (9.0%) were incorrect, among which 36 were not corrected by the interpreting physician. In 12 cases, misdiagnosed atrial fibrillation/flutter led to inappropriate treatment with anticoagulant therapy. A larger proportion of atrial flutters, 27 out of 80 (34%), than atrial fibrillations, 62 out of 908 (7%), were incorrectly diagnosed by the computer. Conclusions: Among ECGs with a computer-based diagnosis of atrial fibrillation or atrial flutter, the diagnosis was incorrect in almost 10%. In almost half of the cases, the misdiagnosis was not corrected by the overreading primary-care physician. Twelve patients received inappropriate anticoagulant treatment as a result of misdiagnosis.Key points Data regarding the incidence of misdiagnosed atrial fibrillation or atrial flutter in primary care are lacking. In a Swedish primary care setting, computer-based ECG interpretations of atrial fibrillation or atrial flutter were incorrect in 89 of 988 (9.0%) consecutive cases. Incorrect computer diagnoses of atrial fibrillation or atrial flutter were not corrected by the primary-care physician in 47% of cases. In 12 of the cases with an incorrect computer rhythm diagnosis, misdiagnosed atrial fibrillation or flutter led to inappropriate treatment with anticoagulant therapy.
(Less)
- author
- Lindow, Thomas LU ; Kron, Josefine ; Thulesius, Hans LU ; Ljungström, Erik and Pahlm, Olle LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- atrial fibrillation, atrial flutter, cardiovascular disease, computer-based interpretation, ECG
- in
- Scandinavian Journal of Primary Health Care
- volume
- 37
- issue
- 4
- pages
- 426 - 433
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:31684791
- scopus:85074557222
- ISSN
- 0281-3432
- DOI
- 10.1080/02813432.2019.1684429
- language
- English
- LU publication?
- yes
- id
- 282b6712-16b5-4991-b1fe-b909ce006724
- date added to LUP
- 2019-11-22 13:38:05
- date last changed
- 2024-06-12 05:08:56
@article{282b6712-16b5-4991-b1fe-b909ce006724,
abstract = {{<p>Objective: To describe the incidence of incorrect computerized ECG interpretations of atrial fibrillation or atrial flutter in a Swedish primary care population, the rate of correction of computer misinterpretations, and the consequences of misdiagnosis. Design: Retrospective expert re-analysis of ECGs with a computer-suggested diagnosis of atrial fibrillation or atrial flutter. Setting: Primary health care in Region Kronoberg, Sweden. Subjects: All adult patients who had an ECG recorded between January 2016 and June 2016 with a computer statement including the words ‘atrial fibrillation’ or ‘atrial flutter’. Main outcome measures: Number of incorrect computer interpretations of atrial fibrillation or atrial flutter; rate of correction by the interpreting primary care physician; consequences of misdiagnosis of atrial fibrillation or atrial flutter. Results: Among 988 ECGs with a computer diagnosis of atrial fibrillation or atrial flutter, 89 (9.0%) were incorrect, among which 36 were not corrected by the interpreting physician. In 12 cases, misdiagnosed atrial fibrillation/flutter led to inappropriate treatment with anticoagulant therapy. A larger proportion of atrial flutters, 27 out of 80 (34%), than atrial fibrillations, 62 out of 908 (7%), were incorrectly diagnosed by the computer. Conclusions: Among ECGs with a computer-based diagnosis of atrial fibrillation or atrial flutter, the diagnosis was incorrect in almost 10%. In almost half of the cases, the misdiagnosis was not corrected by the overreading primary-care physician. Twelve patients received inappropriate anticoagulant treatment as a result of misdiagnosis.Key points Data regarding the incidence of misdiagnosed atrial fibrillation or atrial flutter in primary care are lacking. In a Swedish primary care setting, computer-based ECG interpretations of atrial fibrillation or atrial flutter were incorrect in 89 of 988 (9.0%) consecutive cases. Incorrect computer diagnoses of atrial fibrillation or atrial flutter were not corrected by the primary-care physician in 47% of cases. In 12 of the cases with an incorrect computer rhythm diagnosis, misdiagnosed atrial fibrillation or flutter led to inappropriate treatment with anticoagulant therapy.</p>}},
author = {{Lindow, Thomas and Kron, Josefine and Thulesius, Hans and Ljungström, Erik and Pahlm, Olle}},
issn = {{0281-3432}},
keywords = {{atrial fibrillation; atrial flutter; cardiovascular disease; computer-based interpretation; ECG}},
language = {{eng}},
number = {{4}},
pages = {{426--433}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Primary Health Care}},
title = {{Erroneous computer-based interpretations of atrial fibrillation and atrial flutter in a Swedish primary health care setting}},
url = {{http://dx.doi.org/10.1080/02813432.2019.1684429}},
doi = {{10.1080/02813432.2019.1684429}},
volume = {{37}},
year = {{2019}},
}