Systematic Review and Meta-Analysis of Diagnostic Accuracy to Identify ST-Segment Elevation Myocardial Infarction on Interpretations of Prehospital Electrocardiograms
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- Tanaka Akihito
- Department of Cardiology, Nagoya University Graduate School of Medicine
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- Matsuo Kunihiro
- Department of Acute Care Medicine, Fukuoka University Chikushi Hospital
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- Kikuchi Migaku
- Department of Cardiovascular Medicine, Emergency and Critical Care Center, Dokkyo Medical University
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- Kojima Sunao
- Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital
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- Hanada Hiroyuki
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Mano Toshiaki
- Kansai Rosai Hospital, Cardiovascular Center
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- Nakashima Takahiro
- Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care, University of Michigan
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- Hashiba Katsutaka
- Department of Cardiology, Saiseikai Yokohama-shi Nanbu Hospital
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- Yamamoto Takeshi
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
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- Yamaguchi Junichi
- Department of Cardiology, Tokyo Women’s Medical University
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- Nakayama Naoki
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center
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- Nomura Osamu
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Matoba Tetsuya
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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- Tahara Yoshio
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Nonogi Hiroshi
- Faculty of Health Science, Osaka Aoyama University
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説明
<p>Background: The aim of this study was to assess and discuss the diagnostic accuracy of prehospital ECG interpretation through systematic review and meta-analyses.</p><p>Methods and Results: Relevant literature published up to July 2020 was identified using PubMed. All human studies of prehospital adult patients suspected of ST-segment elevation myocardial infarction in which prehospital electrocardiogram (ECG) interpretation by paramedics or computers was evaluated and reporting all 4 (true-positive, false-positive, false-negative, and true-negative) values were included. Meta-analyses were conducted separately for the diagnostic accuracy of prehospital ECG interpretation by paramedics (Clinical Question [CQ] 1) and computers (CQ2). After screening, 4 studies for CQ1 and 6 studies for CQ2 were finally included in the meta-analysis. Regarding CQ1, the pooled sensitivity and specificity were 95.5% (95% confidence interval [CI] 82.5–99.0%) and 95.8% (95% CI 82.3–99.1%), respectively. Regarding CQ2, the pooled sensitivity and specificity were 85.4% (95% CI 74.1–92.3%) and 95.4% (95% CI 87.3–98.4%), respectively.</p><p>Conclusions: This meta-analysis suggests that the diagnostic accuracy of paramedic prehospital ECG interpretations is favorable, with high pooled sensitivity and specificity, with an acceptable estimated number of false positives and false negatives. Computer-assisted ECG interpretation showed high pooled specificity with an acceptable estimated number of false positives, whereas the pooled sensitivity was relatively low.</p>
収録刊行物
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- Circulation Reports
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Circulation Reports 4 (7), 289-297, 2022-07-08
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