An assessment of ST-segment measurement variability between two core electrocardiogram laboratories.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVES: We evaluated inter-reader agreement of the ST-segment between two electrocardiogram (ECG) core laboratories. BACKGROUND: Accurate measurement of the ST-segment is key to diagnosis and management of acute coronary syndromes (ACS). Clinical trials also rely on adherence to the pre-specified ECG eligibility criteria. METHODS: 150 patients (100 ST-segment elevation (STE)-ACS, 50 non-STE-ACS) were selected. An experienced ECG reader from each laboratory measured ST-segment deviation on the baseline ECGs (nearest 0.1mm). RESULTS: ∑ST-segment deviation showed excellent inter-reader agreement (R=0.965, intraclass correlation coefficient (ICC) 0.949, 95% CI (0.930-0.963)). Similar agreement was observed when ∑ST-segment elevation (∑STE) and ∑ST-segment depression (∑STD) were assessed separately. Better agreement was evident in STE-ACS cohort (ICC (95% CI): 0.968 (0.953-0.978, 0.969 (0.954-0.979), 0.931 (0.899-0.953)) compared to NSTE-ACS patients (ICC (95% CI): 0.860 (0.768-0.917), 0.816 (0.699-0.890), 0.753 (0.605-0.851) across measurement of ∑ST-segment deviation, ∑STE, and ∑STD. CONCLUSIONS: We demonstrated excellent agreement on ST-segment measurements between two experienced readers from two ECG core laboratories.

Full Text

Duke Authors

Cited Authors

  • Dianati Maleki, N; Stocke, K; Zheng, Y; Westerhout, CM; Fu, Y; Chaitman, BR; Awad, A; Jagasia, P; Armstrong, PW

Published Date

  • 2014

Published In

Volume / Issue

  • 47 / 1

Start / End Page

  • 38 - 44

PubMed ID

  • 24246251

Electronic International Standard Serial Number (EISSN)

  • 1532-8430

Digital Object Identifier (DOI)

  • 10.1016/j.jelectrocard.2013.10.005


  • eng

Conference Location

  • United States