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

TY - JOUR

T1 - 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

AU - Lim, HC

AU - Salandanan, EA

AU - Phillips, Rachel

AU - Tan, JG

AU - Hezan, MA

PY - 2015/10

Y1 - 2015/10

N2 - 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.

AB - 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.

U2 - 10.1136/emermed-2014-204102

DO - 10.1136/emermed-2014-204102

M3 - Article

SN - 1472-0213

VL - 32

SP - 809

EP - 812

JO - Emergency medicine journal : EMJ

JF - Emergency medicine journal : EMJ

IS - 10

ER -