Back to Course

Evidenced Based Management: A Journey for Physicians

0% Complete
0/0 Steps
  1. Historical Perspective, Epidemiology, and Methodology
  2. Overview of the SCD guidelines and chapters
  3. Process and methodology
  4. Consensus Statements
  5. Clinical Practice Guidelines and the institute of Medicine
  6. Prevention of invasive infection
  7. Screening for Renal Disease
  8. Electrocardiogram Screening
  9. Screening for hypertension
  10. Screening for Retinopathy
  11. Screening for risk of stroke using neuroimaging
  12. Screening for Pulmonary disease
  13. Reproductive counseling
  14. Contraception
  15. Clinical Preventive services
  16. Immunizations
  17. Vaso-Occlusive Crisis
  18. Fever
  19. Acute Renal Failure
  20. Priapism
  21. Hepatobiliary Complications
  22. Acute Anemia
  23. Splenic Sequestration
  24. Acute Chest Syndrome
  25. Acute Stroke
  26. Multisystem Organ Failure
  27. Acute Ocular Conditions
  28. Chronic pain
  29. Avascular Necrosis
  30. Leg Ulcers
  31. Pulmonary Hypertension
  32. Renal Complications
  33. Stuttering/Recurrent Priapism
  34. Ophthalmologic Complications
  35. Summary of the Evidence
  36. Hydroxurea Treatment Recommendations
  37. Consensus Treatment Protocol and Technical remarks for the implementation of Hydroxyurea Therapy
  38. Indications for transfusions
  39. Recommendations for Acute and Chronic Transfusion Therapy
  40. Appropriate Management/ Monitoring
  41. Consensus Protocol for Monitoring Individuals on Chronic Transfusion Therapy
  42. Complications of Transfusions
  43. Recommendations for the Management and Prevention of Transfusion Complications
  44. New Research is Needed
  45. Data Systems That Meet the Highest Standards of Scientific Rigor Can Be Invaluable
  46. Improved Phenotyping is needed
  47. Broad collaborations for Research and Care
  48. Beyond Efficacy
  49. Look, Listen, Empathize and Ask
Lesson 8 of 49
In Progress

Electrocardiogram Screening

SCFA_Coach September 25, 2023


The electrocardiogram (ECG) may offer diagnostic information to guide clinical decision making. However, there is minimal evidence for the value of obtaining a screening ECG in asymptomatic individuals with or without SCD to detect abnormalities such as prolonged corrected QT interval (QTc), ST-T segment abnormalities, and electrocardiographic cardiac enlargement.

Although observational studies of the prevalence of ECG abnormalities in persons with SCD have been done, they reveal abnormalities that are of unknown clinical significance. Studies found that the prevalence of cardiac enlargement ranged between 22 percent and 76 percent, and ventricular hypertrophy prevalence was found to be between 28 percent and 37 percent. The presence of nonspecific S-T abnormalities was found to be between 18.5 percent and 52 percent. First-degree atrioventricular block was found in 8 percent of people in one study, and intra ventricular conduction delay was found in 4 percent of people in another study.

Prolonged QTc ranged between l5 percent and 50 percent prevalence. Overall, there was no significant difference in the prevalence of prolonged QTc between people with and without SCD, and the presence of prolonged QTe did not significantly affect mortality

Summary of the Evidence
Fourteen observational studies (4 longitudinal and 10 cross-sectional) described the use of ECG as a screening test in people with SCD; however, all of the studies focused on estimating the prevalence of ECG abnormalities of unknown clinical significance. No study evaluated the utility of ECG screening or compared an approach of ECG screening versus no screening, and no data exist about the effect of obtaining a screening ECG on clinical outcomes in people with SCD. There were no data on screening intervals or diagnostic accuracy of the test, and the overall quality of the evidence supporting screening using ECG was very low.

The USPSTF recommends against routine screening with resting electrocardiography, exercise treadmill test (ETT), or electron-beam computerized tomography (EBCT) scanning for coronary calcium for either the presence of severe coronary artery stenosis (CAS) or the prediction of coronary heart disease (CHD) events in adults at low risk for CHD events (Gradmoderate to high certainty that the benefits do not outweigh the harms).

1. Routine ECG screening is not recommended in children and adults with SCD.(Weak Recommendation, Low-Quality Evidence}