Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study

BackgroundVisual expertise refers to advanced visual skills demonstrated when performing domain-specific visual tasks. Prior research has emphasized the fact that medical experts rely on such perceptual pattern-recognition skills when interpreting medical images, particularly...

Full description

Bibliographic Details
Main Authors: Mohammed Tahri Sqalli, Dena Al-Thani, Mohamed B Elshazly, Mohammed Al-Hijji, Alaa Alahmadi, Yahya Sqalli Houssaini
Format: Article
Language:English
Published: JMIR Publications 2022-02-01
Series:JMIR Human Factors
Online Access:https://humanfactors.jmir.org/2022/1/e34058
_version_ 1797735336304967680
author Mohammed Tahri Sqalli
Dena Al-Thani
Mohamed B Elshazly
Mohammed Al-Hijji
Alaa Alahmadi
Yahya Sqalli Houssaini
author_facet Mohammed Tahri Sqalli
Dena Al-Thani
Mohamed B Elshazly
Mohammed Al-Hijji
Alaa Alahmadi
Yahya Sqalli Houssaini
author_sort Mohammed Tahri Sqalli
collection DOAJ
description BackgroundVisual expertise refers to advanced visual skills demonstrated when performing domain-specific visual tasks. Prior research has emphasized the fact that medical experts rely on such perceptual pattern-recognition skills when interpreting medical images, particularly in the field of electrocardiogram (ECG) interpretation. Analyzing and modeling cardiology practitioners’ visual behavior across different levels of expertise in the health care sector is crucial. Namely, understanding such acquirable visual skills may help train less experienced clinicians to interpret ECGs accurately. ObjectiveThis study aims to quantify and analyze through the use of eye-tracking technology differences in the visual behavior and methodological practices for different expertise levels of cardiology practitioners such as medical students, cardiology nurses, technicians, fellows, and consultants when interpreting several types of ECGs. MethodsA total of 63 participants with different levels of clinical expertise took part in an eye-tracking study that consisted of interpreting 10 ECGs with different cardiac abnormalities. A counterbalanced within-subjects design was used with one independent variable consisting of the expertise level of the cardiology practitioners and two dependent variables of eye-tracking metrics (fixations count and fixation revisitations). The eye movements data revealed by specific visual behaviors were analyzed according to the accuracy of interpretation and the frequency with which interpreters visited different parts/leads on a standard 12-lead ECG. In addition, the median and SD in the IQR for the fixations count and the mean and SD for the ECG lead revisitations were calculated. ResultsAccuracy of interpretation ranged between 98% among consultants, 87% among fellows, 70% among technicians, 63% among nurses, and finally 52% among medical students. The results of the eye fixations count, and eye fixation revisitations indicate that the less experienced cardiology practitioners need to interpret several ECG leads more carefully before making any decision. However, more experienced cardiology practitioners rely on their skills to recognize the visual signal patterns of different cardiac abnormalities, providing an accurate ECG interpretation. ConclusionsThe results show that visual expertise for ECG interpretation is linked to the practitioner’s role within the health care system and the number of years of practical experience interpreting ECGs. Cardiology practitioners focus on different ECG leads and different waveform abnormalities according to their role in the health care sector and their expertise levels.
first_indexed 2024-03-12T12:57:32Z
format Article
id doaj.art-69f99940bbc240878c997d3297ad6708
institution Directory Open Access Journal
issn 2292-9495
language English
last_indexed 2024-03-12T12:57:32Z
publishDate 2022-02-01
publisher JMIR Publications
record_format Article
series JMIR Human Factors
spelling doaj.art-69f99940bbc240878c997d3297ad67082023-08-28T20:45:29ZengJMIR PublicationsJMIR Human Factors2292-94952022-02-0191e3405810.2196/34058Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking StudyMohammed Tahri Sqallihttps://orcid.org/0000-0002-6171-8070Dena Al-Thanihttps://orcid.org/0000-0002-1474-2692Mohamed B Elshazlyhttps://orcid.org/0000-0002-5802-692XMohammed Al-Hijjihttps://orcid.org/0000-0002-9572-7688Alaa Alahmadihttps://orcid.org/0000-0002-4846-116XYahya Sqalli Houssainihttps://orcid.org/0000-0003-0452-5181 BackgroundVisual expertise refers to advanced visual skills demonstrated when performing domain-specific visual tasks. Prior research has emphasized the fact that medical experts rely on such perceptual pattern-recognition skills when interpreting medical images, particularly in the field of electrocardiogram (ECG) interpretation. Analyzing and modeling cardiology practitioners’ visual behavior across different levels of expertise in the health care sector is crucial. Namely, understanding such acquirable visual skills may help train less experienced clinicians to interpret ECGs accurately. ObjectiveThis study aims to quantify and analyze through the use of eye-tracking technology differences in the visual behavior and methodological practices for different expertise levels of cardiology practitioners such as medical students, cardiology nurses, technicians, fellows, and consultants when interpreting several types of ECGs. MethodsA total of 63 participants with different levels of clinical expertise took part in an eye-tracking study that consisted of interpreting 10 ECGs with different cardiac abnormalities. A counterbalanced within-subjects design was used with one independent variable consisting of the expertise level of the cardiology practitioners and two dependent variables of eye-tracking metrics (fixations count and fixation revisitations). The eye movements data revealed by specific visual behaviors were analyzed according to the accuracy of interpretation and the frequency with which interpreters visited different parts/leads on a standard 12-lead ECG. In addition, the median and SD in the IQR for the fixations count and the mean and SD for the ECG lead revisitations were calculated. ResultsAccuracy of interpretation ranged between 98% among consultants, 87% among fellows, 70% among technicians, 63% among nurses, and finally 52% among medical students. The results of the eye fixations count, and eye fixation revisitations indicate that the less experienced cardiology practitioners need to interpret several ECG leads more carefully before making any decision. However, more experienced cardiology practitioners rely on their skills to recognize the visual signal patterns of different cardiac abnormalities, providing an accurate ECG interpretation. ConclusionsThe results show that visual expertise for ECG interpretation is linked to the practitioner’s role within the health care system and the number of years of practical experience interpreting ECGs. Cardiology practitioners focus on different ECG leads and different waveform abnormalities according to their role in the health care sector and their expertise levels.https://humanfactors.jmir.org/2022/1/e34058
spellingShingle Mohammed Tahri Sqalli
Dena Al-Thani
Mohamed B Elshazly
Mohammed Al-Hijji
Alaa Alahmadi
Yahya Sqalli Houssaini
Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study
JMIR Human Factors
title Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study
title_full Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study
title_fullStr Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study
title_full_unstemmed Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study
title_short Understanding Cardiology Practitioners’ Interpretations of Electrocardiograms: An Eye-Tracking Study
title_sort understanding cardiology practitioners interpretations of electrocardiograms an eye tracking study
url https://humanfactors.jmir.org/2022/1/e34058
work_keys_str_mv AT mohammedtahrisqalli understandingcardiologypractitionersinterpretationsofelectrocardiogramsaneyetrackingstudy
AT denaalthani understandingcardiologypractitionersinterpretationsofelectrocardiogramsaneyetrackingstudy
AT mohamedbelshazly understandingcardiologypractitionersinterpretationsofelectrocardiogramsaneyetrackingstudy
AT mohammedalhijji understandingcardiologypractitionersinterpretationsofelectrocardiogramsaneyetrackingstudy
AT alaaalahmadi understandingcardiologypractitionersinterpretationsofelectrocardiogramsaneyetrackingstudy
AT yahyasqallihoussaini understandingcardiologypractitionersinterpretationsofelectrocardiogramsaneyetrackingstudy