对荷兰全科医生引进单导联心电图仪和数字心脏病专家咨询平台的评估

Evert P.M. Karregat, Marlou A. de Koning, Jelle C.L. Himmelreich, David W. Koetsier, Jonas S.S.G. de Jong, Eric P. Moll van Charante, Ralf E. Harskamp, Wim A.M. Lucassen
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引用次数: 0

摘要

目的:评估单导联心电图(1L-ECG)设备和数字心脏病专家咨询平台在全科医生(GPs)诊断心律失常中的应用。背景:手持式单导联心电图(1L-ECG)为全科医生提供了一种替代传统 12 导联心电图的用户友好型设备。虽然全科医生可以通过 1L-ECG 记录安全地排除心律失常,但要确认可疑的心律失常,则需要专家会诊。全科医生在日常工作中使用 1L-ECG 设备和数字会诊平台的经验鲜为人知。首先,在一项观察性研究中,我们收集并描述了全科医生在当地全科医生合作组织发起的数字心脏病医生会诊平台上分享的所有病例。该全科医生合作组织向所有附属全科医生(n = 203)分发了 KardiaMobile 1L-ECG 设备,并邀请他们加入该会诊平台。在第二部分中,我们使用在线问卷对这些全科医生使用 KardiaMobile 和会诊平台的经验进行了评估。结果:共有 98 名(48%)全科医生参与了该项目,其中 48 名(49%)分享了 156 个病例。专家小组能够为 130 个(83.3%)共享病例提供明确的心律解释,回答时间中位数为 4 分钟(IQR:2-18)。回答问卷的全科医生(n = 43;44%)认为,KardiaMobile 在初级保健的心律诊断方面具有附加值(n = 42;98%),而且易于使用(n = 41;95%)。大多数全科医生(n = 36;84%)重视心脏病专家在咨询平台上提供的反馈意见。全科医生认为该项目对(疑似)心律失常患者的护理质量和诊断效率都有积极影响。虽然我们缺乏对全科医生遇到的障碍的全面了解,但他们提到解决技术问题有助于进一步的实施。我们还需要开展更多研究,探讨全科医生不积极使用这些工具的原因,并评估实际临床影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the introduction of a single-lead ECG device and digital cardiologist consultation platform among general practitioners in the Netherlands
Aim:

To evaluate the use of a single-lead electrocardiography (1L-ECG) device and digital cardiologist consultation platform in diagnosing arrhythmias among general practitioners (GPs).

Background:

Handheld 1L-ECG offers a user-friendly alternative to conventional 12-lead ECG in primary care. While GPs can safely rule out arrhythmias on 1L-ECG recordings, expert consultation is required to confirm suspected arrhythmias. Little is known about GPs’ experiences with both a 1L-ECG device and digital consultation platform for daily practice.

Methods:

We used two distinct methods in this study. First, in an observational study, we collected and described all cases shared by GPs within a digital cardiologist consultation platform initiated by a local GP cooperative. This GP cooperative distributed KardiaMobile 1L-ECG devices among all affiliated GPs (n = 203) and invited them to this consultation platform. In the second part, we used an online questionnaire to evaluate the experiences of these GPs using the KardiaMobile and consultation platform.

Findings:

In total, 98 (48%) GPs participated in this project, of whom 48 (49%) shared 156 cases. The expert panel was able to provide a definitive rhythm interpretation in 130 (83.3%) shared cases and answered in a median of 4 min (IQR: 2–18). GPs responding to the questionnaire (n = 43; 44%) thought the KardiaMobile was of added value for rhythm diagnostics in primary care (n = 42; 98%) and easy to use (n = 41; 95%). Most GPs (n = 36; 84%) valued the feedback from the cardiologists in the consultation platform. GPs experienced this project to have a positive impact on both the quality of care and diagnostic efficiency for patients with (suspected) cardiac arrhythmias. Although we lack a comprehensive picture of experienced impediments by GPs, solving technical issues was mentioned to be helpful for further implementation. More research is needed to explore reasons of GPs not motivated using these tools and to assess real-life clinical impact.

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