ECG over-reading services

Remote ECG screening is one of CompuMed's core business services. An over-read, or follow-up review by a cardiologist, is performed by CompuMed's expert cardiologists using our industry-leading CardioGram systems.

While CompuMed highly recommends using its CardioGram ECG systems (as requesting ECG over-reads is instantaneous and automated on these machines), CompuMed can and will provide ECG over-reading services to users of other ECG machines as long as the received ECG is legible (contact CompuMed for information).

Why is an ECG over-read by an expert cardiologist important?

A perspective from David M. Frisch, M.D., F.A.C.C., CompuMed's lead cardiologist:

• Why is an ECG over-read important?
  Dr. Frisch: "An over-read helps resolve the problem of over interpreted or under-interpreted tracings. In other words, it helps ensure that ECG results are interpreted accurately. This in turn can save the patient's life."
  
  
• How accurate are machine interpretations? Do they vary by program?
  Dr. Frisch: "In my experience, the error rate for machine interpretations in terms of false abnormals or normals is about 25%, and different over-read automated software programs each have their own weaknesses."
  
  
• Why is it important to have a cardiologist perform an over-read? Can't a nurse or other kind of doctor do the reads?
  Dr. Frisch: "If an over-read is required it must be performed by a qualified physician. There are serious medical and legal implications and liabilities if an over-read result is inaccurate. Physician extenders (e.g., PAs or NPs) are simply not qualified for this job, and most internists or GPs don't read ECGs as well as a computer program, which also does not provide reliable over-read results. It's very difficult to teach a non-cardiologist to read ECGs properly on par with a cardiologist."
  
  
• What makes CompuMed cardiologists unique?
  Dr. Frisch: "CompuMed's cardiologists are on the faculty of leading medical schools such as UCLA Medical School, and have taught ECG reading courses for decades. Their credentials and experience lend very valuable credibility to CompuMed's service. If a legal dispute arises, CompuMed cardiologists have the credibility and gravitas to defend our client's legal position."

Excerpts from peer-reviewed scientific papers:

• "Expert overreading of the ECG remains important in clinical settings with a high percentage of nonsinus rhythms."
        Shah AP, Rubin SA. J Electrocardiol. 2007 Sep;40(5):385-90.
  
  
• "The most frequent errors in computer ECG interpretation are related to arrhythmias, conduction disorders, and electronic pacemakers. Computer ECG diagnosis of life threatening conditions e.g. acute myocardial infarction or high degree AV blocks are frequently not accurate (40.7% and 75.0% errors, respectively)."
        Guglin ME, Thatai D. Int J Cardiol. 2006 Jan 13;106(2):232-7.
  
  
• "Computer diagnosis of paced rhythms remains problematic, and physician overreading to correct computer-based electrocardiogram rhythm diagnoses remains mandatory".
        Poon K, et al. J Electrocardiol. 2005 Oct;38(4):345-6.
  
  
• "Incorrect computerized interpretation of atrial fibrillation, combined with the failure of the ordering physician to correct the erroneous interpretation, can result in the initiation of unnecessary, potentially harmful medical treatment as well as inappropriate use of medical resources."
        Bogun F, et al. Am J Med. 2004 Nov 1;117(9):636-42.
  
  
• "We speculate that distributing the computer-generated interpretation to the ED physicians and formal review of all ED ECGs by a skilled interpreter may decrease the number of missed diagnoses."
        Snyder CS, et al. Pediatr Cardiol. 2003 Jul-Aug;24(4):364-8.