Telecardiology avoided hospitalization in 84 of 134 patients judged as having a cardiac event by GPs, and identified events in 56 of 322 patients initially judged as not having one.
Observational (n=456)
Does telecardiology improve diagnostic accuracy and reduce unnecessary hospital admissions in patients with suspected cardiac events evaluated by general practitioners?
Telecardiology significantly improves diagnostic accuracy and reduces unnecessary hospitalizations for patients with suspected cardiac events in primary care.
We studied the role of telecardiology in reducing unnecessary hospital admissions of patients with suspected life-threatening cardiac events (CEs), evaluated by general practitioners (GPs). Over one month, 456 consecutive patients (mean age 65 years, SD 19) complaining of typical (10%) or atypical (42%) chest pain, palpitations (19%), dyspnoea (19%) or syncope (10%) were enrolled. Before teleconsultation, the GPs recorded their own opinion (based on clinical evaluation only) about the presence of a CE. Following transmission of the electrocardiogram (ECG), this opinion was compared with that of the cardiologist. In total there was agreement between the GP and cardiologist about the presence of a CE in 316 of the patients (69%) and disagreement in 140 patients (31%). This represents a specificity and sensitivity of the GPs' diagnosis of 76% and 47%, respectively. For 84 of 134 patients judged as having a CE by the GP, telecardiology avoided hospitalization; on the other hand, telecardiology identified a CE in 56 of 322 patients judged as not having a CE by the GP. Telecardiology is a useful tool with which to reduce unnecessary hospitalizations in patients with suspected life-threatening CEs.
Molinari et al. (Mon,) conducted a observational in Suspected life-threatening cardiac events (n=456). Telecardiology (ECG transmission and cardiologist consultation) vs. General practitioner clinical evaluation alone was evaluated on Agreement between general practitioner and cardiologist about the presence of a cardiac event. Telecardiology avoided hospitalization in 84 of 134 patients judged as having a cardiac event by GPs, and identified events in 56 of 322 patients initially judged as not having one.