Inter-rater reliability of J-point location and measurement of the magnitude of ST segment elevation at the J-point on ECGs of STEMI patients by emergency department doctors

HC Lim, EA Salandanan, Rachel Phillips, JG Tan, MA Hezan

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5 Citations (Scopus)

Abstract

INTRODUCTION AND OBJECTIVES:
Identification of the J-point and measurement of ST segment elevation at the J-point are important for the diagnosis of ST-elevation myocardial infarction (STEMI). We conducted a study to determine the inter-rater reliability (IRR) of J-point location and measurement of the magnitude of ST elevation at the J-point on ECGs of patients with STEMI by emergency department (ED) doctors.

SUBJECTS AND METHODS:
Each participant examined 20 STEMI ECGs during a 1-month period in 2013. The participants were required to locate the J-point by selecting the small 1 mm square within which the J-point is located and measure the magnitude of ST elevation at the J-point identified (rounded up to the nearest 0.5 mm). The intraclass correlation coefficient (ICC) was calculated to assess the IRR.

RESULTS:
Thirty doctors participated. The ICC assessing the degree to which all participants provided agreement in their assessment of the location of J-points across ECGs was 0.85 (95% CI 0.75 to 0.93), which is in the excellent range. The ICC for assessing the magnitude of ST elevation was 0.97 (95% CI 0.94 to 0.98), indicating excellent agreement as well.

CONCLUSIONS:
ED doctors show a high level of agreement when determining the location of J-points and measuring the magnitude of ST elevation at those J-points on ECGs of patients with STEMI. The findings support the measurement of ST segment elevation at the J-point in STEMI cases and should be regarded as a consistent standard to avoid confusion.
Original languageEnglish
Pages (from-to)809-812
JournalEmergency medicine journal : EMJ
Volume32
Issue number10
Early online date23 Jan 2015
DOIs
Publication statusPublished - Oct 2015

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