Purpose

Electrocardiograms (ECG) are often poorly interpreted by novices and this can delay time-sensitive, critical intervention. This study aimed to assess, improve and validate a stepwise ECG algorithm designed to assist with ECG interpretation by novices by soliciting the opinions of an international cohort of expert cardiologists.

Methods

The Delphi Method was used, and an online questionnaire was sent to an international panel of cardiologists. Experts were required to evaluate each step of the algorithm and offer comments. Feedback was analysed by the investigators, changes to the algorithm were made and these were sent back to the experts until a consensus was reached. Two rounds of the Delphi Method were required to achieve consensus.

Results

Overall, 55 responses were achieved (round one = 33, round two = 22). The average agreement in round one was 90.2% with 25 changes from 124 comments. Round two achieved 93.4% agreement with 12 changes from 57 comments. The threshold for consensus was set at 90% and was confirmed as being reached by all four investigators of this study. A final algorithm was therefore established. The ECG algorithm was validated through a rigorous two-stage development and review process.

Conclusions

The algorithm was validated as a safe, informative tool for novices to use to improve ECG interpretation. Real-world user validation is now required to further improve the algorithm.

中文翻译：

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帮助新手解读心电图的算法：使用 Delphi 方法进行验证

目的

心电图 (ECG) 常常被新手解释得很差，这可能会延迟时间敏感的关键干预。本研究旨在评估、改进和验证逐步心电图算法，该算法旨在通过征求国际心脏病专家队列的意见，帮助新手解读心电图。

方法

使用了德尔菲法，并向国际心脏病专家小组发送了一份在线问卷。专家被要求评估算法的每个步骤并提供评论。调查人员分析了反馈，对算法进行了更改，并将这些更改发送回专家，直到达成共识。需要两轮德尔菲法才能达成共识。

结果

总体而言，获得了 55 个响应（第一轮 = 33，第二轮 = 22）。第一轮的平均同意率为 90.2%，124 条评论中有 25 处更改。第二轮对 57 条评论中的 12 处更改达成了 93.4% 的一致意见。达成共识的阈值设定为 90%，并确认本研究的所有四名研究者都达到了共识。因此建立了最终算法。ECG 算法通过严格的两阶段开发和审查过程进行了验证。

结论

该算法被验证为一种安全、信息丰富的工具，可供新手用来改进心电图解释。现在需要真实世界的用户验证来进一步改进算法。