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Erroneous computer-based interpretations of atrial fibrillation and atrial flutter in a Swedish primary health care setting
Region Kronoberg, Sweden;Lund University, Sweden.
Region Kronoberg, Sweden.
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Region Kronoberg, Sweden.
Region Skåne, Sweden.
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2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 4, p. 426-433Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019. Vol. 37, no 4, p. 426-433
Keywords [en]
ECG, atrial fibrillation, atrial flutter, computer-based interpretation, cardiovascular disease
National Category
Cardiac and Cardiovascular Systems
Research subject
Natural Science, Medicine
Identifiers
URN: urn:nbn:se:lnu:diva-90199DOI: 10.1080/02813432.2019.1684429ISI: 000494058900001PubMedID: 31684791OAI: oai:DiVA.org:lnu-90199DiVA, id: diva2:1371888
Available from: 2019-11-21 Created: 2019-11-21 Last updated: 2019-12-06Bibliographically approved

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