724 research outputs found
Clinical impact and diagnostic accuracy of 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (PET/CT) brain imaging in patients with cognitive impairment: a tertiary centre experience in the UK
Accuracy of methods for diagnosing atrial fibrillation using 12-lead ECG: a systematic review and meta-analysis
Background: Screening for atrial fibrillation (AF) using 12-lead-electrocardiograms (ECGs) has been recommended; however, the best method for interpreting ECGs to diagnose AF is not known. We compared accuracy of methods for diagnosing AF from ECGs.
Methods: We searched MEDLINE, EMBASE, CINAHL and LILACS until March 24, 2014. Two reviewers identified eligible studies, extracted data and appraised quality using the QUADAS-2 instrument. Meta-analysis, using the bivariate hierarchical random effects method, determined average operating points for sensitivities, specificities, positive and negative likelihood ratios (PLR, NLR) and enabled construction of Summary Receiver Operating Characteristic (SROC) plots.
Results: 10 studies investigated 16 methods for interpreting ECGs (n = 55,376 participant ECGs). The sensitivity and specificity of automated software (8 studies; 9 methods) were 0.89 (95% C.I. 0.82β0.93) and 0.99 (95% C.I. 0.99β0.99), respectively; PLR 96.6 (95% C.I. 64.2β145.6); NLR 0.11 (95% C.I. 0.07β0.18). Indirect comparisons with software found healthcare professionals (5 studies; 7 methods) had similar sensitivity for diagnosing AF but lower specificity [sensitivity 0.92 (95% C.I. 0.81β0.97), specificity 0.93 (95% C.I. 0.76β0.98), PLR 13.9 (95% C.I. 3.5β55.3), NLR 0.09 (95% C.I. 0.03β0.22)]. Sub-group analyses of primary care professionals found greater specificity for GPs than nurses [GPs: sensitivity 0.91 (95% C.I. 0.68β1.00); specificity 0.96 (95% C.I. 0.89β1.00). Nurses: sensitivity 0.88 (95% C.I. 0.63β1.00); specificity 0.85 (95% C.I. 0.83β0.87)].
Conclusions: Automated ECG-interpreting software most accurately excluded AF, although its ability to diagnose this was similar to all healthcare professionals. Within primary care, the specificity of AF diagnosis from ECG was greater for GPs than nurses
Lectures on physiology, zoology, and the natural history of man, delivered at the Royal College of Surgeons by William Lawrence.
Lectures on physiology, zoology, and the natural history of man, delivered at the Royal College of Surgeons by William Lawrence.
Reports.
Mode of access: Internet.Official record of the activities of the laboratory continued in the Report of the curator
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