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In Reply to Berger and Yiadom

      We thank Drs. Berger and Yiadom for their comments regarding our article on electrocardiogram (ECG)-to-activation (ETA) time, and we wish to address their concerns about this metric, its application to ST-elevation myocardial infarction (STEMI) delays, and its use for quality improvement (
      • Berger DA
      • Yiadom MYAB.
      ECG to activation: not an appropriate physician metric, but a worthy process metric.
      ).
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      1. McLaren JTT, Meyers HP, Smith SW, Chartier LB. From STEMI to occlusion MI: paradigm shift and quality improvement [published online ahead of print December 30, 2021]. CJEM doi:10.1007/s43678-021-00255-z

      Linked Article

      • ECG to Activation: Not an Appropriate Physician Metric, but a Worthy Process Metric
        Journal of Emergency MedicineVol. 62Issue 1
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          In the recently published paper titled, “Using ECG-To-Activation Time to Assess Emergency Physicians’ Diagnostic Time for Acute Coronary Occlusion,” the authors conclude that ECG [electrocardiogram]-to-activation (ETA) “can serve as a quality metric for emergency physicians” (1). There is value in directing attention to the ETA interval within the ST-elevation myocardial infarction (STEMI) care pathway from screening to treatment. However, we suggest caution with the use of ETA as a metric for physician performance comparisons.
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