Diagnosis of right bundle branch block : A concordance study
Alventosa-Zaidin, Marina (Institut Català de la Salut)
Pera, Guillem (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Roca Saumell, Carme (Institut Català de la Salut. Centre d'Atenció Primària El Clot (Barcelona, Catalunya))
Mengual Miralles, N. (Institut Català de la Salut)
Zamora Sanchez, M. V. (Institut Català de la Salut)
Gros Garcia, Teresa (Institut Català de la Salut)
Guix Font, Laia (Servei Català de la Salut)
Benitez-Camps, Mencia (Institut Català de la Salut)
Francisco Pascual, Jaume (Hospital Universitari Vall d'Hebron)
Brugada, Josep 1958- (Hospital Clínic i Provincial de Barcelona)

Data:	2019
Resum:	Background: Right bundle branch block is one of the most common electrocardiographic abnormalities. Most cases of right bundle branch block are detected in asymptomatic patients in primary care, so a correct interpretation of electrocardiograms (ECGs) at this level is necessary. The objective of this research is to determine the degree of concordance in the diagnosis of incomplete and complete right bundle branch block between four primary care researchers and a cardiologist. Methods: The research design is a retrospective cohort study of patients over 18 years of ages of patients over 18 years of ages who underwent an ECG for any reason and were diagnosed with right bundle branch block by their physician. The physicians participating, 4 primary care researchers and a cardiologist were specialized in interpreting electrocardiographic records. The diagnosis of incomplete and complete right bundle branch block was recorded and other secondary variables were analysed. In case of diagnostic discordance between the researchers, the ECGs were reviewed by an expert cardiologist, who interpreted them, established the diagnosis and analysed the possible causes for the discrepancy. Results: We studied 160 patients diagnosed with right bundle branch block by their general practise. The patients had a mean age of 64. 8 years and 54% of them were men. The concordance in the diagnosis of incomplete right bundle branch block showed a Fleiss' kappa index (k) of 0. 71 among the five researchers and of 0. 85 among only the primary care researchers. The k for complete right bundle branch block was 0. 93 among the five researchers and 0. 96 among only the primary care researchers. Conclusion: The interobserver agreement in the diagnosis of right bundle branch block performed by physicians specialized in ECG interpretation (primary care physicians and a cardiologist) was very good. The variability was greater for the diagnosis of incomplete right bundle branch block.
Nota:	Altres ajuts: 12th grant for research in Primary Care from the Catalan Society of Family Medicine (CAMFIC)(2012); Research scholarship for the accomplishment of the doctorate in primary care from University Institute for Research in Primary Care (IDIAP) Jordi Gol (2014): Gonçal Calvo Research Scholarship from the Academy of Medical and Health Sciences of Catalonia and the Balearic Islands (filial Maresme)(2015); Research scholarship for primary care professionals of the Catalan Health Institute (area Barcelona city)(2017)
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Concordance ; Bundle branch block
Publicat a:	BMC family practice, Vol. 20 Núm. 1 (may 2019) ,, ISSN 1471-2296

DOI: 10.1186/s12875-019-0946-3
PMID: 31060516

9 p, 1.2 MB

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