Sensitivity and specificity and likelihood ratios of three ECG interpretation criteria
| ESC recommendations | Seattle Criteria | Refined Criteria | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Combined athletes: Arabic, black and Caucasian | +ve ECG | −ve ECG | +ve ECG | −ve ECG | +ve ECG | −ve ECG | |||
| +ve path. | 10 | 0 | +ve path. | 10 | 0 | +ve path. | 10 | 0 | |
| −ve path. | 400 | 1308 | −ve path. | 213 | 1495 | −ve path. | 102 | 1606 | |
| Positive predictive value (%) (95% CI) | 2.4 (1.2 to 4.4) | 4.5 (2.2 to 8.1) | 8.9 (4.37 to 15.81) | ||||||
| Sensitivity (%) (95% CI) | 100 (69.0 to 100) | 100 (69.0 to 100) | 100 (69.0 to 100) | ||||||
| Specificity (%) (95% CI) | 76.6 (74.5 to 78.6) | 87.5* (85.9 to 89.1) | 94.0*† (92.8 to 95.1) | ||||||
| Positive likelihood ratio (95% CI) | 4.3 (3.9 to 4.7) | 8.0* (7.1 to 9.1) | 16.8*† (13.9 to 20.2) | ||||||
| Black athletes | +ve ECG | −ve ECG | +ve ECG | −ve ECG | +ve ECG | −ve ECG | |||
| +ve path. | 6 | 0 | +ve path. | 6 | 0 | +ve path. | 6 | 0 | |
| −ve path. | 168 | 383 | −ve path. | 90 | 461 | −ve path. | 54 | 497 | |
| Positive predictive value (%) (95% CI) | 3.4 (1.3 to 7.4) | 6.2 (2.3 to 13.1) | 10 (3.8 to 20.5) | ||||||
| Sensitivity (%) (95% CI) | 100 (54.1 to 100) | 100 (54.1 to 100) | 100 (54.1 to 100) | ||||||
| Specificity (%) (95% CI) | 69.5 (65.5 to 73.3) | 83.7 (80.3 to 86.7)* | 90.2 (87.4 to 92.5)*† | ||||||
| Positive likelihood ratio (95% CI) | 3.3 (1.8 to 3.6) | 6.1 (3.2 to 7.1)* | 10.2 (5.3 to 12.5)*† | ||||||
| Arabic athletes | +ve ECG | −ve ECG | +ve ECG | −ve ECG | +ve ECG | −ve ECG | |||
| +ve path. | 4 | 0 | +ve path. | 4 | 0 | +ve path. | 4 | 0 | |
| −ve path. | 185 | 750 | −ve path. | 104 | 831 | −ve path. | 41 | 894 | |
| Positive predictive value (%) (95% CI) | 2.1 (0.6 to 5.3) | 3.7 (1.0 to 9.2) | 8.9 (2.5 to 21.2) | ||||||
| Sensitivity (%) (95% CI) | 100 (39.8 to 100) | 100 (39.8 to 100) | 100 (39.8 to 100) | ||||||
| Specificity (%) (95% CI) | 80.2 (75.6 to 82.7) | 88.9* (86.7 to 90.8) | 95.6*† (94.1 to 96.8) | ||||||
| Positive likelihood ratio (95% CI) | 5.1 (12.2 to 5.4) | 9.0* (3.8 to 10.1) | 22.8*† (9.4 to 28.8) | ||||||
*Significantly different from ESC recommendations.
†Significantly different from Seattle Criteria.
ESC, European Society of Cardiology; +ve ECG, abnormal ECG; −ve ECG, normal ECG; +ve path., identified cardiac pathology; −ve path., no identified cardiac pathology.