Diagnostic Accuracy Measures of the Interpretation of 1L-ECG by Cardiologists or the Smartphone Algorithm Using 12L-ECG as Reference Standard
| Outcome Assessed | % Sensitivity (95% CI) | % Specificity (95% CI) | LR+ (95% CI) | LR– (95% CI) | % PPV (95% CI) | % NPV (95% CI) |
|---|---|---|---|---|---|---|
| Atrial fibrillation or flutter | ||||||
| Cardiologists | 100 (85.2-100) | 100 (98.1-100) | ∞a | 0b | 100c | 100c |
| Smartphone algorithm | 87.0 (66.4-97.2) | 97.9 (94.7-99.4) | 41.5 (15.5-110.9) | 0.13 (0.05-0.38) | 83.3 (65.2-93.0) | 98.4 (95.6-99.4) |
| Any rhythm abnormality | ||||||
| Cardiologists | 90.9 (78.3-97.5) | 93.5 (88.7-96.7) | 14.1 (7.9-25.1) | 0.10 (0.04-0.25) | 78.4 (67.1-86.7) | 97.6 (94.0-99.0) |
| Any conduction abnormality | ||||||
| Cardiologists | 46.4 (27.5-66.1) | 100 (98.0-100) | ∞a | 0.54 (0.38-0.76) | 100c | 92.5 (89.8-94.6) |
1L = single-lead; 12L = 12-lead; ECG = electrocardiography; LR+ = positive likelihood ratio; LR– = negative likelihood ratio; NPV = negative predictive value; PPV = positive predictive value.
↵a LR+ is infinite and 95% CI is not applicable when specificity = 100%.14
↵b LR– is 0 and 95% CI is not applicable when sensitivity = 100%.14
↵c 95% CI is not applicable when PPV or NPV = 100%.14,15