High Accuracy of School-Based Cardiovascular Screening System in Kagoshima City

Abstract

Background: A school-based cardiovascular (CV) screening in Kagoshima City is characterized by a group discussion system. Pediatric cardiologists discuss whether electrocardiograms (ECGs), screened by a cardiolo-gist, should be referred for the second examination. Here, we examined the accuracy of the screening system in Kagoshima City. Methods: Subjects comprised 67,723 elementary and junior high school students who underwent the screening between 1989 and 2018. In Kagoshima City, the standard 12-lead ECG recording at the first screening was started in 1994, and the group discussion system was introduced in 2001. We analyzed the rate of the first ECG screening, the rate of patients with CV diseases through the screening, and the rate of patients with CV diseases, including those already diagnosed (total prevalence). Results: The rate of the first screening after the group discussion system (1.5 ％ [1.2 ‒ 2.2 ％ ] (median [range])) was significantly lower than that before the system (2.4 ％ [1.9 ‒ 3.0 ％ ]). The CV disease rate through the screening between 2001 and 2018 was significantly higher than that between 1994 and 2000 (43 ％ [33 ‒ 50 ％ ] vs. 28 ％ [26 ‒ 35 ％ ]). The total CV disease rate was 0.60 ％ [0.50 ‒ 0.85 ％ ]. Conclusions: The accuracy of the screening system in Kagoshima City was sufficiently high because the total CV disease rate was similar to that of the national average (0.9 ％ ), although the first screening rate was lower than that of the national average (3.0 ％ ). The group discussion system might support this high accuracy in addi-tion to the use of 12-lead ECGs.