According to the findings of a study led by researchers from Stanford University, cardiologists appear to make mistakes frequently when interpreting the results of young athletes’ pre-participation screening ECGs.
Pediatric cardiologists who participated in the study had an accuracy rate of just 69%. The study, according to the authors, suggests that diseases underlying sudden cardiac death are difficult to interpret in athletes. The accuracy rate did not differ significantly in respondents, despite variations in length of time practicing pediatric cardiology, the number of ECGs read per month, or practice type.
In the investigation, 53 pediatric cardiologists were asked to interpret a series of 18 ECGs of athletes with either normal hearts or conditions that would lead to sudden cardiac death. Per cardiologist, the average number of correct interpretations was 12.4. Sensitivity for detecting a cardiac abnormality was 68%, and specificity was 70%. False-positive results were 30%, and false-negative results were 32%.
An accurate restriction of athletic participation was given in 81% of cases, compared with 74% of cases in which healthy patients were accurately allowed to participate in sports. The most common cases in which correct guidance was provided were for long-QT syndrome and myocarditis. Correct guidance was provided least often in cases of hypertrophic cardiomyopathy and Wolff-Parkinson-White syndrome. This finding was particularly “disappointing” to the researchers, who noted that the most frequent cause of sudden cardiac death in the United States is hypertrophic cardiomyopathy.
Physicians Weekly wants to know…
- What consequences could arise from the false sense of security offered to patients and families when choices are made by cardiologist to not restrict athletic participation despite evidence on an ECG of cardiac abnormalities?
- Do you believe you may have misread a pre-participation screening ECG?
- What do you think can be done to avoid misinterpretation of pre-participation screening ECGs?