Source
Lancashire + South Cumbria
Cardiac Network, 2007
BMJ, Jonathan Mant, 2007
(Birmingham?), (mainly atrial
fibrillation), trial on elderly
patients
Wikipedia
JAMA (the Journal of American
Medical Association), 2012 Philip
Greenland
US Preventive Services Task Force
2004/revised 2012 (mainly CHD)
Utrecht Health Project
Spain 2007
University of Rome Sapieza, 2009
Conclusion: No real value in annual scans for the elderly. Only useful if already risk factors e.g.
diabetes, hypertension etc. More likely to increase paranoia/worry patients.
For
Some anticipated clinical outcomes
changed on basis of ECG
interpretation.
4% patients with unsuspected
arrhythmias were found.
GPs detected 79/99 cases
Practitioners had no other
information about patients, pure
yes/no answer based on ECG
Follow up of 8 years (more than
20% had major/minor ECG
abnormalities) found slight link
between abnormalities and
increased risk of CHD.
Reclassification into a higher risk
category might lead to more
intensive medical management
that could lower the risk for CHD
events.
Risk-benefit trade off would be
most favourable if persons can be
accurately reclassified from
intermediate to high risk.
Useful for hypertensive patients.
ECG abnormalities in patients with
type 2 diabetes mellitus can
predict future cardiovascular
events more accurately than risk
factors alone.
Link between ECG abnormalities
and renal damage.
Against
Low percentages as supporting
evidence
Misinterpreted 114/1355 cases of
sinus rhythm as atrial fibrillation.
Many primary care professionals
can’t accurately detect atrial
fibrillation from an ECG.
Overuse more likely to supply
incorrect supporting evidence for a
non-existent problem.
Tests falsely indication existence of
a problem leads to misdiagnosis,
invasive procedures,
overtreatment…
Conclusion of study was arguments
for ECG screening were not
compelling.
Potential harms equal/exceed
benefits.
Might result in harms including
medication adverse effects such as
gastrointestinal bleeding + hepatic
injury.
Too many risk factors for CHD so
ECG not extensive anyway.
Abnormalities often present
anyway.