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COMPARISON OF THREE METHODS OF SCREENING FOR PEDIATRIC HEART DISEASE

William Morton, M.D.; Murray S. Hoffman, M.D.; Roy L. Cleere, M.D., M.P.H.; Horace J. Dodge, M.D., M.P.H.
JAMA. 1959;169(11):1169-1172. doi:10.1001/jama.1959.03000280021006.
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Three screening methods were compared as to specificity and sensitiveness in the detection of cardiac abnormalities by applying them to each of 5,654 children. The three methods consisted of a single-lead (V3R) electrocardiogram, a miniature chest roentgenogram, and a limited physical examination. For each method it was possible to define a sensitivity index, a specificity index, and their product, an efficiency index. The V3R gave a specificity index of 0.190 (ratio of true positive to total positive findings), and of 58 children with abnormal V3R tracings 44 had normal hearts. The physical examination, used singly, was the most specific and the most sensitive and gave the highest efficiency index, but none of the methods was infallible.

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