Dear Editor,

I read the article titled effect of cross-industry standard process for data minin (CRISP) method training on electrocardiography (ECG) diagnosis skills of prehospital medical services personnel by Ekici et al. (1) with great interest, and I would like to address some points that merit more attention. ECG assessment is an important aspect in prehospital care. Unfortunately, many healthcare personnel have limited knowledge of ECG, and they should receive regular training in order to detect fatal and emergency-related ECG changes (2).

In their study, Ekici et al. (1) evaluated the effectiveness of the CRISP method and divided the study population into control and experimental groups. The analysis showed that the CRISP method was more successful in recognizing sinus rhythm, supraventricular tachycardia, atrial fibrillation, second-degree Mobitz type-1, and Mobitz type-2 atrioventricular blocks. However, no statistically significant difference was found between the two groups for sinus bradycardia, second-degree Mobitz type-2 atrioventricular block, atrial flutter, third-degree atrioventricular block, ventricular tachycardia, ventricular fibrillation, and asystole. Studies have shown that third-degree atrioventricular block, pulseless ventricular tachycardia, and ventricular fibrillation are among the leading causes of sudden cardiac death, and that a quick diagnosis and initiation of treatment are crucial (3, 4). The fact that the CRISP method did not show superiority in these conditions can be considered a limitation of the study in terms of evaluating prehospital emergency cases.

Moreover, the ischemic findings such as ST-segment elevation and depression, which should be quickly identified in prehospital ECG, were not evaluated in the study by Ekici et al. (1). As mentioned in the introduction of the study, early detection of acute cardiac ischemic conditions in the prehospital setting is important for ensuring appropriate hospital transfer and facilitating rapid cardiac catheterization (5). If the study had included evaluations of ST-segment changes in the ECG, it could have contributed more meaningfully to the literature and yielded more appropriate results.

Using traditional or contemporary methods, providing ECG training to healthcare personnel working in prehospital medical services at regular intervals will automatically improve their ECG assessment capabilities.