Key result
The smartphone-based 12-lead ECG detected STEMI with 86.3% accuracy and 87.5% sensitivity, compared to 80.85% accuracy and 98.4% sensitivity for the gold standard 12-lead hospital ECG.
Why the study?
Because early detection and treatment are essential for patient survival in STEMI, this study evaluated the accuracy of a smartphone 12-lead ECG system compared to a standard hospital ECG machine.
Does a smartphone-based 12-lead ECG accurately detect STEMI compared to a standard 12-lead hospital ECG in patients with suspected acute coronary syndrome?
Cross-Sectional (n=154)
Single blinded
Non-randomised
No
Does a smartphone-based 12-lead ECG accurately detect STEMI compared to a standard 12-lead hospital ECG in patients with suspected acute coronary syndrome?
Absolute Event Rate: 86.3% vs 80.85%
A smartphone-based 12-lead ECG system demonstrated high sensitivity and accuracy for detecting STEMI, suggesting its potential utility as a portable diagnostic tool in resource-constrained or prehospital settings.
May support prehospital STEMI screening in limited settings; leaves open prospective validation before clinical adoption.
Background: When a severe heart attack called a ST segment elevation myocardial infarction (STEMI) is not treated, heart muscle is killed per minute. Hence, early detection and treatment are essential for patient survival. The objectives of this study were to evaluate the accuracy for detection of (a) the ST elevation myocardial infarction of smartphone 12 lead ECG system in comparison to 12 lead gold standard hospital ECG machine; and (b) classification of STEMI in smartphone ECG and hospital ECG. Methods: This prospective, cross sectional study, non-randomised, single blinded and single-center study was carried out at Shri Mahant Indresh Hospital (SMIH), Dehradun, Uttarakhand, India from 30 May 2022 to 17 January 2023. All patients (n=154) with chest pain, shortness of breath, palpitation under the observations before and after the Percutaneous coronary intervention (PCI) like Coronary angioplasty, bypass surgery were enrolled from Critical care unit (CCU) and intensive critical care unit (ICCU). Results: Mean age (SD) was 53.90±11.7 years. The male gender (83.12%) shows the maximum frequency than female gender. True positive cases derived from confusion matrix for 12 lead standard ECG and smartphone ECG in comparison to cardiologist diagnosis was 113 as compared to 129 from 12 lead Gold standard. Sensitivity of smartphone Spandan ECG (87.5%) was comparable to gold standard 12 lead ECG (98.4%). And, specificity and PPV of smartphone Spandan ECG was recorded to be better than gold standard 12 Lead ECG. STEMI was detected correctly in 132 (86.3%) cases and 141 (80.85%) cases by smartphone ECG and 12 lead Gold standard, respectively. Conclusions: Spandan ECG device scored a high accuracy and sensitivity. The overall accuracy of smartphone ECG in detecting the STEMI increased by 5.45%, i.e. the significance rise in accuracy of computer interpretation when compared to the cardiologists’ diagnosis.
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Mahajan et al. (2023) conducted a cross-sectional in ST-elevation myocardial infarction (STEMI) (n=154). Smartphone-based 12-lead ECG (Spandan) vs. Standard 12-lead hospital ECG machine was evaluated on Accuracy of STEMI detection. The smartphone-based 12-lead ECG detected STEMI with 86.3% accuracy and 87.5% sensitivity, compared to 80.85% accuracy and 98.4% sensitivity for the gold standard 12-lead hospital ECG.
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