Validation of the 3-lead tele-ECG versus the 12-lead tele-ECG and the conventional 12-lead ECG method in older people

J Telemed Telecare. 2012 Mar;18(2):104-8. doi: 10.1258/jtt.2011.110613. Epub 2012 Jan 20.


We compared the diagnostic accuracy of 3-lead tele-ECGs to both 12-lead tele-ECGs and a conventional 12-lead ECG device (the gold standard). The subjects were older people (n = 107) with a mean age of 66 years. The overall agreement between two cardiologists on interpreting the 3-lead tele-ECG recordings was 97% (kappa = 0.96, P < 0.001) and it was 91% for the 12-lead tele-ECGs (kappa = 0.90, P < 0.001). We also found excellent agreement on the interpretation of the 3-lead tele-ECGs compared to the gold standard: 98% (kappa = 0.96, P < 0.001) and for the 12-lead tele-ECG compared to the gold standard: 98% (kappa = 0.96, P < 0.001). Bland-Altman plots showed that the apparent differences between the techniques were not clinically relevant. The use of a 3-lead tele-ECG device may be useful for reducing the delay in treating specific heart disease conditions, e.g. in older people affected by chronic heart disease who need frequent ECG monitoring.

Publication types

  • Validation Study

MeSH terms

  • Aged
  • Cardiology / methods
  • Electrocardiography / instrumentation*
  • Electrocardiography / methods
  • Electrocardiography / standards*
  • Female
  • Heart Diseases / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Self Care / methods*
  • Telemedicine / methods*
  • Telemetry / methods*