The West Jutland Tele-Electrocardiogram Registry (WEJU-tECG): content,data quality,and research potential

Abstract

Aim:

To present the content, data quality, and research potential of the West Jutland Tele-Electrocardiogram Registry (WEJU-tECG).

Methods:

Danish patients reporting symptoms indicating heart disease in the prehospital setting are subjected to a 12-lead tele-electrocardiogram (ECG) in the ambulance, which is digitally sent to a local tele-centre. WEJU-tECG is a newly established Danish registry containing information from the individual tele-ECGs received at the Regional Hospital West Jutland tele-centre.

Results:

WEJU-tECG holds extracted information from all tele-ECGs with a valid Civil Personal Register number between 2011 and 2020. WEJU-tECG contains information on patient characteristics, tele-ECG data (including a computerised tele-ECG interpretation), vital signs, and time information. A unique Civil Personal Register number allows individual-level linkage between WEJU-tECG and other Danish registries and enables complete follow-up. WEJU-tECG contains 43,696 tele-ECGs from 29,489 different patient contacts among 20,280 different patients. WEJU-tECG contains 5566 patients with ST-segment deviations. The median age is 67 years and 45% are women. Completeness is highest for time information (100% for all variables), tele-ECG data (99% for heart rate, the specific intervals and axes, and QRS duration, and 86% for J-point deviation), and patient characteristics (100% for all variables). Completeness is lowest for vital signs (13% for systolic, diastolic, and mean arterial blood pressure, and 12% for blood oxygen saturation). The computerised tele-ECG interpretation had a negative predictive value of 80% for ST-segment elevation myocardial infarction and 94% for non-ST-segment elevation myocardial infarction and a positive predictive value of 45% for ST-segment elevation myocardial infarction and 32% for non-ST-segment elevation myocardial infarction.

Conclusions:

WEJU-tECG is a novel population-based tele-ECG registry with high research potential.

Keywords

Data resource paper tele-electrocardiogram prehospital diagnosis prehospital treatment epidemiology cardiology emergency medical services computerised electrocardiogram interpretation workload

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References

Sørensen

. Regional administrative health registries as a resource in clinical epidemiology: a study of options, strengths, limitations and data quality provided with examples of use. Int J Risk Safety Med 1997;10:1–22. 1997/01/01. DOI: 10.3233/jrs-1997-10101

Schmidt

Pedersen

Sørensen

. The Danish Civil Registration System as a tool in epidemiology. Eur J Epidemiol 2014;29:541–549. 2014/06/26. DOI: 10.1007/s10654-014-9930-3

Schmidt

Sandegaard

, et al. The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 2015;7:449–490. 2015/11/26. DOI: 10.2147/clep.S91125

Pottegård

Schmidt

SAJ

Wallach-Kildemoes

, et al. Data Resource Profile: the Danish National Prescription Registry. Int J Epidemiol 2017;46:798–798f. 2016/10/30. DOI: 10.1093/ije/dyw213

Schmidt

Maeng

Madsen

, et al. The Western Denmark Heart Registry: its influence on cardiovascular patient care. J Am Coll Cardiol 2018;71:1259–1272. 2018/03/17. DOI: 10.1016/j.jacc.2017.10.110

Schmidt

SAJ

Adelborg

, et al. The Danish health care system and epidemiological research: from health care contacts to database records. Clin Epidemiol 2019;11:563–591. 2019/08/03. DOI: 10.2147/clep.S179083

Henriksen

Rasmussen

Hansen

, et al. Comparison of the five Danish regions regarding demographic characteristics, healthcare utilization, and medication use – a descriptive cross-sectional study. PloS One 2015;10:e0140197–e0140197. DOI: 10.1371/journal.pone.0140197

Hospitalsenheden Vest: Om os. https://www.regionshospitalet-goedstrup.dk/om-os/ (accessed 13 April 2022).

Lindskou

Mikkelsen

Christensen

, et al. The Danish prehospital emergency healthcare system and research possibilities. Scand J Trauma Resusc Emerg Med 2019;27:100. 2019/11/07. DOI: 10.1186/s13049-019-0676-5

10.

Terkelsen

Nørgaard

Lassen

, et al. Telemedicine used for remote prehospital diagnosing in patients suspected of acute myocardial infarction. J Intern Med 2002;252:412–420. 2003/01/17. DOI: 10.1046/j.1365-2796.2002.01051.x

11.

Ibanez

James

Agewall

, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2017;39:119–177. DOI: 10.1093/eurheartj/ehx393

12.

Andersen

Johnsen

Sørensen

, et al. Implementing a nationwide criteria-based emergency medical dispatch system: a register-based follow-up study. Scand J Trauma Resusc Emerg Med 2013;21:53. 2013/07/10. DOI: 10.1186/1757-7241-21-53

13.

Cannon

Gibson

Lambrew

, et al. Relationship of symptom-onset-to-balloon time and door-to-balloon time with mortality in patients undergoing angioplasty for acute myocardial infarction. JAMA 2000;283:2941–2947. 2000/06/24. DOI: 10.1001/jama.283.22.2941

14.

Sørensen

Terkelsen

Nørgaard

, et al. Urban and rural implementation of pre-hospital diagnosis and direct referral for primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction. Eur Heart J 2011;32:430–436. 2010/12/09. DOI: 10.1093/eurheartj/ehq437

15.

Sejersten

Sillesen

Hansen

, et al. Effect on treatment delay of prehospital teletransmission of 12-lead electrocardiogram to a cardiologist for immediate triage and direct referral of patients with ST-segment elevation acute myocardial infarction to primary percutaneous coronary intervention. Am J Cardiol 2008;101:941–946. 2008/03/25. DOI: 10.1016/j.amjcard.2007.11.038

16.

Grann

Erichsen

Nielsen

, et al. Existing data sources for clinical epidemiology: the clinical laboratory information system (LABKA) research database at Aarhus University, Denmark. Clin Epidemiol 2011;3:133–138. 2011/04/14. DOI: 10.2147/clep.S17901

17.

Helweg-Larsen

. The Danish Register of Causes of Death. Scand J Public Health 2011;39:26–29. 2011/08/04. DOI: 10.1177/1403494811399958

18.

Andersen

Olivarius Nde

Krasnik

. The Danish National Health Service Register. Scand J Public Health 2011;39:34–37. 2011/08/04. DOI: 10.1177/1403494810394718

19.

Christensen

Lau

Kristensen

, et al. The Danish National Health Survey: study design, response rate and respondent characteristics in 2010, 2013 and 2017. Scand J Public Health 2020;50:180–188. 2020/11/10. DOI: 10.1177/1403494820966534

20.

Danish Pacemaker and ICD Register Annual Report 2019. https://www.sundhed.dk/content/cms/21/109821_dpir_annual_report_2019_final_211220.pdf (accessed 13 April 2022).

21.

Stengaard

Sørensen

Ladefoged

, et al. The potential of optimizing prehospital triage of patients with suspected acute myocardial infarction using high-sensitivity cardiac troponin T and copeptin. Biomarkers 2017;22:351–360. 2016/12/03. DOI: 10.1080/1354750x.2016.1265008

22.

Rasmussen

Stengaard

Sørensen

, et al. Comparison of acute versus subacute coronary angiography in patients with non-ST-elevation myocardial infarction (from the NONSTEMI Trial). Am J Cardiol 2019;124:825–832. 2019/07/22. DOI: 10.1016/j.amjcard.2019.06.007

23.

Nielsen

Graff

Pietersen

, et al. J-shaped association between QTc interval duration and the risk of atrial fibrillation: results from the Copenhagen ECG study. J Am Coll Cardiol 2013;61:2557–2564. 2013/04/16. DOI: 10.1016/j.jacc.2013.03.032

24.

Rasmussen

Nielsen

Skov

, et al. Electrocardiographic PR interval duration and cardiovascular risk: results from the Copenhagen ECG Study. Can J Cardiol 2017;33:674–681. 2017/04/30. DOI: 10.1016/j.cjca.2017.02.015

25.

Skov

Rasmussen

Ghouse

, et al. Electrocardiographic preexcitation and risk of cardiovascular morbidity and mortality: results from the Copenhagen ECG Study. Circ Arrhythm Electrophysiol 2017;10:e004778. 2017/06/04. DOI: 10.1161/circep.116.004778

26.

Ribeiro

ALP

Paixão

GMM

Gomes

, et al. Tele-electrocardiography and bigdata: the CODE (Clinical Outcomes in Digital Electrocardiography) study. J Electrocardiol 2019;57s:S75–s78. 2019/09/19. DOI: 10.1016/j.jelectrocard.2019.09.008

27.

Schläpfer

Wellens

. Computer-interpreted electrocardiograms: benefits and limitations. J Am Coll Cardiol 2017;70:1183–1192. 2017/08/26. DOI: 10.1016/j.jacc.2017.07.723

28.

Willems

Arnaud

van Bemmel

, et al. Assessment of the performance of electrocardiographic computer programs with the use of a reference data base. Circulation 1985;71:523–534. 1985/03/01. DOI: 10.1161/01.cir.71.3.523

29.

Willems

Abreu-Lima

Arnaud

, et al. The diagnostic performance of computer programs for the interpretation of electrocardiograms. N Engl J Med 1991;325:1767–1773. 1991/12/19. DOI: 10.1056/nejm199112193252503

30.

Kudenchuk

Maynard

Cobb

, et al. Utility of the prehospital electrocardiogram in diagnosing acute coronary syndromes: the Myocardial Infarction Triage and Intervention (MITI) Project. J Am Coll Cardiol 1998;32:17–27. 1998/07/21. DOI: 10.1016/s0735-1097(98)00175-2

31.

Jernberg

Attebring

Hambraeus

, et al. The Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART). Heart 2010;96:1617–1621. 2010/08/31. DOI: 10.1136/hrt.2010.198804

32.

Belle

Cayla

Cottin

, et al. French Registry on Acute ST-elevation and non-ST-elevation Myocardial Infarction 2015 (FAST-MI 2015): design and baseline data. Arch Cardiovasc Dis 2017;110:366–378. 2017/06/26. DOI: 10.1016/j.acvd.2017.05.001

33.

Reiffel

Kowey

Myerburg

, et al. Practice patterns among United States cardiologists for managing adults with atrial fibrillation (from the AFFECTS Registry). Am J Cardiol 2010;105:1122–1129. 2010/04/13. DOI: 10.1016/j.amjcard.2009.11.046

34.

Yang

, et al. The China Acute Myocardial Infarction (CAMI) Registry: a national long-term registry-research-education integrated platform for exploring acute myocardial infarction in China. Am Heart J 2016;175:193–201.e193. 2016/05/18. DOI: 10.1016/j.ahj.2015.04.014

35.

Zheng

Bainey

Tyrrell

, et al. Relationships between baseline Q waves, time from symptom onset, and clinical outcomes in ST-segment-elevation myocardial infarction patients: insights from the Vital Heart Response Registry. Circ Cardiovasc Interv 2017;11:e005399. 2017/11/18. DOI: 10.1161/circinterventions.117.005399

36.

Goodman

Huang

Yan

, et al. The expanded Global Registry of Acute Coronary Events: baseline characteristics, management practices, and hospital outcomes of patients with acute coronary syndromes. Am Heart J 2009; 158:193–201;e191–195. 2009/07/22. DOI: 10.1016/j.ahj.2009.06.003

37.

Le Heuzey

Breithardt

Camm

, et al. The RecordAF study: design, baseline data, and profile of patients according to chosen treatment strategy for atrial fibrillation. Am J Cardiol 2010;105:687–693. 2010/02/27. DOI: 10.1016/j.amjcard.2009.10.012

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