Abstract
Drug-induced long QT syndrome (diLQTS), characterized by a prolongation of the QT-interval on the electrocardiogram (ECG), is a serious adverse drug reaction that can cause the life-threatening arrhythmia Torsade de Points (TdP). Self-monitoring for diLQTS could therefore save lives, but detecting it on the ECG is difficult, particularly at high and low heart rates. In this paper, we evaluate whether using a pseudo-colouring visualisation technique and changing the coordinate system (Cartesian vs. Polar) can support lay people in identifying QT-prolongation at varying heart rates. Four visualisation techniques were evaluated using a counterbalanced repeated measures design including Cartesian no-colouring, Cartesian pseudo-colouring, Polar no-colouring and Polar pseudo-colouring. We used a multi-reader, multi-case (MRMC) receiver operating characteristic (ROC) study design within a psychophysical paradigm, along with eye-tracking technology. Forty-three lay participants read forty ECGs (TdP risk n = 20, no risk n = 20), classifying each QT-interval as normal/abnormal, and rating their confidence on a 6-point scale. The results show that introducing pseudo-colouring to the ECG significantly increased accurate detection of QT-interval prolongation regardless of heart rate, T-wave morphology and coordinate system. Pseudo-colour also helped to reduce reaction times and increased satisfaction when reading the ECGs. Eye movement analysis indicated that pseudo-colour helped to focus visual attention on the areas of the ECG crucial to detecting QT-prolongation. The study indicates that pseudo-colouring enables lay people to visually identify drug-induced QT-prolongation regardless of heart rate, with implications for the more rapid identification and management of diLQTS.
Original language | English |
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Article number | e0237854 |
Journal | P L o S One |
Volume | 15 |
Issue number | 8 |
DOIs | |
Publication status | Published - 27 Aug 2020 |
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Dive into the research topics of 'Pseudo-colouring an ECG enables lay people to detect QT-interval prolongation regardless of heart rate'. Together they form a unique fingerprint.Impacts
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Making ECGs intuitively explainable to the public for early detection of life-threatening heart conditions (ECG-X)
Caroline Jay (Participant), Alaa Alahmadi (Participant), Markel Vigo (Participant), Alan Davies (Participant), Jennifer Royle (Participant), Leanna Goodwin (Participant), Katharine Cresswell (Participant), Zahra Arain (Participant) & Katherine Dempsey (Participant)
Impact: Technological, Health and wellbeing