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How Do Cardiology Practitioners Interpret an Electrocardiogram: An Eye Tracking Study (Preprint)

JMIR human factors(2021)

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摘要
BACKGROUND Visual expertise refers to advanced visual skills demonstrated when executing domain‐specific visual tasks. Understanding healthcare practitioners’ visual expertise across different levels in the healthcare sector is crucial in clarifying how to acquire accurate interpretations of electrocardiograms (ECGs). OBJECTIVE The study aims to quantify, through the use of eye-tracking, differences in the visual expertise of medical practitioners, such as medical students, cardiology nurses, technicians, fellows, and consultants, when interpreting ECGs. METHODS Sixty-three participants with different healthcare roles participated in an eye-tracking study that consisted of interpreting 10 ECGs with different heart abnormalities. A counterbalanced within-subjects design was employed with one independent variable consisting of the expertise level of the medical practitioners and two measured eye-tracking dependent variables (fixations count and fixations revisitation). Eye-tracking data was assessed according to the accuracy of interpretation and frequency interpreters visited different leads in ECGs. In addition, the median and standard deviation in the interquartile range for the fixations count and the mean and standard deviation for the ECG lead revisitations were calculated. RESULTS Accuracy of interpretation ranged between 98% among consultants and 52% among medical students. Eye-tracking features also reflected this difference in the accuracy of interpretation. The results of the eye fixations count and eye fixations revisitations indicate that the less experienced medical practitioners need to observe various ECG leads more carefully. However, experienced medical practitioners rely on visual pattern recognition to provide their ECG diagnoses. CONCLUSIONS The results show that visual expertise for ECG interpretation is linked to the practitioner’s role within the healthcare system and the number of years of practical experience interpreting ECGs. Medical practitioners focus on different ECG leads and different waveform abnormalities according to their role in the healthcare sector and their expertise levels.
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关键词
electrocardiograms,cardiology practitioners,interpretations,eye-tracking
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