An assessment of ST-segment measurement variability between two core electrocardiogram laboratories
Neda Dianati Maleki1, Karen Stocke2, Yinggan Zheng1
1Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
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.
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Acute Coronary Syndrome III: Diagnostic Studies


