Evaluation of computerized interpretation of the pediatric electrocardiogram

The purpose of this research was to determine the frequency and factors affecting disagreement between pediatric cardiologist (MD1 or MD2) and the computer-assisted interpretation (CAI) of pediatric electrocardiograms from patients with heart disease (HD, n = 586) or normal heart (n = 561). Significant disagreement was found in HD (146/586, 25%) compared with normal heart (64/561, 11%) (P < .001). The CAI overinterpreted prolonged QT, sinus rhythm with ectopy, and right ventricular hypertrophy; CAI underinterpreted sinus rhythm, sinus arrhythmia, and right bundle branch block (P < .05). Increased disagreement was independently associated with HD (odds ration [OR], 2.2), younger patient age at the time of the electrocardiogram, if the computer interpretation had more than 3 separate diagnostic statements (OR, 3.2) and if the overreading cardiologist was MD1 (OR, 2.9). Although CAI is helpful, pediatric cardiologists were more likely to disagree with the computer in rhythm diagnosis, recognition of bundle branch block, hypertrophy, and QT interval analysis.