Investigating the effect of clinical history before electrocardiogram interpretation on the visual behavior and interpretation accuracy of clinicians

Scientific Reports
Alan DaviesCaroline Jay

Abstract

We examine the impact of the presentation of a patient's clinical history on subsequent visual appraisal and interpretation accuracy of electrocardiograms (ECGs). Healthcare-practitioners (N = 31) skilled in 12-lead ECG interpretation took part in a repeated-measures experiment with counterbalancing viewing 9 ECGs on a computer screen in two separate conditions: with/without an associated patient-history. A Hellinger-distance calculation was applied using a permutation test to eye-movement transitions at two granularity levels: between the ECG leads, and between smaller grid-cells, whose size was determined via data-driven clustering of the fixation points. Findings indicate that presentation of clinical-history does affect accuracy of interpretation in one ECG. Visual-behavior differed as a function of both history presentation and accuracy when considering transitions between the data-driven grid units (using a fine granularity, and able to show attention to parts of the waveform). Differences in visual-behavior at waveform level demonstrate an influence of patient-history and expertise that are not detected at the lead level. Visual-behaviour differs according to whether a patient-history is presented, and whether a clinicia...Continue Reading

References

Mar 3, 1999·Journal of General Internal Medicine·R HatalaL R Brooks
Aug 8, 2001·Journal of Evaluation in Clinical Practice·B H Bornstein, A C Emler
Jul 28, 2005·The British Journal of Radiology·D J ManningE A Krupinski
Jun 24, 2008·Journal of Electrocardiology·Paul Mele
Jun 22, 2013·Journal of the American Medical Informatics Association : JAMIA·Georgia TourassiElizabeth Krupinski
Jul 3, 2013·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Greg WoodMark R Wilson
Dec 2, 2015·Journal of Electrocardiology·Pentti M Rautaharju
Aug 26, 2017·Journal of the American College of Cardiology·Jürg Schläpfer, Hein J Wellens

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